Free Online Library: Hiperplasia condilar, diagnostico y manejo clinico a proposito de un caso clinico.(CASO CLINICO, Ensayo) by “Revista Facultad de. Case report. Facial asymmetry secondary to mandibular condylar hyperplasia. A case report. Alberto Wintergerst Fisch,* Carlos Iturralde Espinosa,§ Santiago. Title: Tratamento da assimetria facial causada por hiperplasia condilar: série de casos. (Portuguese); Alternate Title: Treatment of facial asymmetry caused by.
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The macrocospic morphology of the condyle has recently been analyzed by two studies published by the group at the Universidad de La Frontera Olate et al. The patient was hospitalized for 2 days and received antibiotics, anti-inflammatory drugs, and analgesics.
CH type 1 refers to an accelerated and prolonged growth aberration of the “normal” mandibular condylar growth mechanism, causing a predominantly horizontal growth vector and resulting in prognathism that can occur bilaterally CH type 1A or unilaterally CH type 1B. The surgery was in charge of the maxillofacial surgeon Juan Carlos Lopez Noriega and the fourth-year resident Carlos Acosta Behrends from the department of maxillofacial surgery. The classification and diagnose of CH, the condyles’ growth activity, and hiperplaxia alternatives are presented in this study.
Microcomputed tomographic analysis of human condyles in unilateral condylar hyperplasia: According to the classification system proposed by Wolford et al.
Hiperplasia condilar, diagnostico y manejo clinico a proposito de un caso clinico.
The patient is subjected to a Cone Beam CT scan to be sure that there was no damage to the external cortical of the maxilla. Intermaxillar fixation was used after surgery. hjperplasia
For aesthetical purposes an advancement genioplasty was performed. The CBCT at 1 month showed a clear and distinct slice of the condyle without defects or irregularities; the distance from the condylar remnant to the articular fossa reached 8.
Condylar hyperplasia is a condition that affects not only the proportions and facial symmetry in patients, but also static and dynamic occlusion functions with repercussions in the masticatory activity, the health of the temporomandibular joint TMJand the anatomy and volume of adjacent soft tissues. After consulting with the patient, the following treatment plan is chosen: You can change the settings or obtain more information by clicking here.
A major concern in TMJ surgery is inadvertent injury to the maxillary artery, given its bleeding potential and the well-known need for hemostasis.
Presurgical orthodontic treatment is of the utmost importance. Histopatologic comparison of normal and hyperplasic condyles. The variables observed were condylar morphology, presence of cortical bone and spatial relation with articular fossa, employing a descriptive and qualitative analysis for their study. However, the Risdon submandibular approach was also mentioned as being used for excision of the lesion in the mandibular condyle.
The first type is caused by unilateral growth in the vertical plane. There was only one case of recurrence, a patient who was first diagnosed with CH type 1 based on facial morphology, imaging tests, and facial growth pattern. A gammagraphy was requested with the purpose of ruling out active condylar growth Figure 3.
Tratamento da assimetria facial causada por hiperplasia condilar: série de casos.
If the maxillary plane does not follow the mandibular plane, on that side, an open bite will develop. C- Bone scintigraphy showing the right mandibular condyle with bone metabolic activity. CBCT image of hyperplastic condyle prior to surgery.
Condylar morphology revealed the presence of a curved area similar to the morphology of a normal condyle, although with the smaller head Fig. Female patient, 37 years of age Figure 1. Often premature contacts of the contralateral side at molar level are produced, preventing full elevation of the treated condyle. The objective of this article is to report the case of a patient with a diagnosis of unilateral CH, anterior disc displacement, and hiperplassia deformity who was treated with low condylectomy, articular disc repositioning and anchoring, and orthognathic surgery, describing the surgical planning and technique used as a way to help dental surgeons in the management of these cases.
An intermaxillary fixation was placed and the ihperplasia had his mouth closed for four weeks Figure 7.
To the knowledge of these authors, there is nothing in the anatomy, pathology or surgery literature regarding hiiperplasia use of magnetic resonance to study these conditions or reports of follow-up with CBCT, so it is difficult to compare our results. Nine subjects were included in this study 6 female and 3 hioerplasia with an average age of At the same time, the choice of vertical osteotomies in the mandible along with the posterior maxillary intrusion allowed the redirection of the mandible by counter-clockwise rotation Figure Using computed microtomography it was recently observed that the hyperplastic condyle has an increase in cancellous bone, disorganized, with perforations in the condylar head Karssemakers et al.
Facial asymmetry secondary to condylar hyperplasia is not merely an aesthetic problem, it can represent functional alterations such as hperplasia and oral opening impairment. UCH has been widely analyzed in recent years without obtaining any clear consensus in terms of etiology and diagnosis Olate et al. Hyperplasia of the mandibular condyle: Access was obtained to the upper and lower joint spaces of the TMJ and condylar process, where a low condylectomy was performed hiper;lasia removal of approximately 8 mm of the condyle.
TMJ radiographs and CT scans may show changes in the size and morphology of the mandibular condyle and condylar neck.
HIPERPLASIA CONDILAR: CARACTERÍSTICAS, MANIFESTACIONES, DIAGNÓSTICO Y TRATAMIENTO. REVISIÓN DE TEMA
Some CH classification systems have been proposed. Comparison of the pre and post-surgical CAT scans. This article can be read in its full version in the following page: In every case an increase was observed in the size of the condyle in all the relations observed, on the axial, coronal and sagittal planes. The left TMJ and articular disc remained unchanged.
It is characterized by oral commissure asymmetry, with little or no deviation of the chin, intraorally, an increase of the maxillary alveolar bone height can be observed as well as a downward deviation of the ipsilateral occlusal plane.
We must take into consideration the limitations that a treatment may have when it is performed only by orthodontic camouflage, as well as the anatomical limitations that orthognathic surgery has in severe discrepancies such as the present case.
Histologically, the osteochondroma consists of a proliferative bony mass covered by a cap of fibrocartilage and hyaline cartilage surrounded by fibrous tissue of the perichondrium, and ossification in the deep portion of the cartilage. Prior to surgery routine laboratory analysis are carried out and additionally, a bone scan SPECT bone of the skull and facial massif with MDP-Tcm was requested to make sure that there was no active cell proliferation at the level of the condyle which could cause a relapse in the asymmetry and the laterognathia caused by the condylar hyperplasia on the right side.