Hyperplasia of the Mandibular Condyle: Clinical, Histopathologic, and Treatment Considerations in a Series of 36 Patients.
Summary of "Hyperplasia of the Mandibular Condyle: Clinical, Histopathologic, and Treatment Considerations in a Series of 36 Patients."
PURPOSE:
Mandibular condylar hyperplasia (CH) is a rare entity that causes overdevelopment of the mandible, creating functional and esthetic problems. The aim of this article was to describe demographic and clinical characteristics of CH, analyze histopathologic features and their association with scintigraphic and clinical findings, and evaluate esthetic and functional results after treatment by high condylectomy during the active phase. MATERIALS AND
METHODS:
This retrospective study included 36 patients whose condyles were removed because of excessive unilateral growth resulting in facial asymmetry and occlusal disturbance. Of the 36 patients, 13 had had symptoms related to the temporomandibular joint, such as pain or clicking. In all the cases, high condylectomy was performed, and surgical specimens were sent for histologic examination and divided into 4 histologic types as described by Slootweg and Müller. Statistical analysis was performed by use of R software (version 2.10.1; R Foundation for Statistical Computing, Vienna, Austria) and SPSS software for Windows (version 15.0; SPSS, Chicago, IL) to evaluate our results. A χ(2) test was carried out to assess the possible association between gender and involved side. The association of histologic appearance with clinical symptoms was estimated by use of the Fisher exact test. An analysis of variance test was performed to evaluate a possible association between patient age and histologic type according to the Slootweg and Müller classification and between histologic type and uptake on bone single photon emission computed tomography (SPECT).
RESULTS:
We could not find a relationship between histologic type and uptake of the affected condyle on bone SPECT or between age and histologic type. However, our statistical analysis revealed an association between histologic appearance and the presence of joint symptoms (P = .0049). Clinically, occlusion and facial symmetry improved in all patients postoperatively, and no recurrence was noted in any patient. Six patients required secondary surgery.
CONCLUSION:
We could not find any significant association between age and histologic type or between bone SPECT and histologic type. However, a significant association between histologic type and temporomandibular joint symptoms was observed. High condylectomy combined with orthodontics achieved optimal esthetic and functional results and constituted the unique and definitive treatment in 30 of 36 patients.
Affiliation
Resident Surgeon.
Journal Details
This article was published in the following journal.
Name: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
ISSN: 1531-5053
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20828911
- DOI: http://dx.doi.org/10.1016/j.joms.2010.04.025
Medical and Biotech [MESH] Definitions
Mandibular Condyle
The posterior process on the ramus of the mandible composed of two parts: a superior part, the articular portion, and an inferior part, the condylar neck.
Endometrial Hyperplasia
Benign proliferation of the ENDOMETRIUM in the UTERUS. Endometrial hyperplasia is classified by its cytology and glandular tissue. There are simple, complex (adenomatous without atypia), and atypical hyperplasia representing also the ascending risk of becoming malignant.
Aroclors
Industrial chemicals which have become widespread environmental pollutants. Each aroclor is a mixture of chlorinated biphenyls (1200 series) or chlorinated terphenyls (5400 series) or a combination of both (4400 series).
Trigeminal Nerve Diseases
Diseases of the trigeminal nerve or its nuclei, which are located in the pons and medulla. The nerve is composed of three divisions: ophthalmic, maxillary, and mandibular, which provide sensory innervation to structures of the face, sinuses, and portions of the cranial vault. The mandibular nerve also innervates muscles of mastication. Clinical features include loss of facial and intra-oral sensation and weakness of jaw closure. Common conditions affecting the nerve include brain stem ischemia, INFRATENTORIAL NEOPLASMS, and TRIGEMINAL NEURALGIA.
Temporomandibular Joint Disk
A plate of fibrous tissue that divides the temporomandibular joint into an upper and lower cavity. The disk is attached to the articular capsule and moves forward with the condyle in free opening and protrusion. (Boucher's Clinical Dental Terminology, 4th ed, p92)
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