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Combined Hemimandibular Hyperplasia and Elongation: the Orthodontic-Surgical Management Ciarán Devine Anna Sayan Velupillai Ilankovan Dental Update 2024 13:3, 707-709.
Authors
CiaránDevine
BDentSc, Dip PCD RCSI, MFD RCSI
Specialty Registrar in Orthodontics, Royal London Hospital and Whipps Cross Hospital
Patients commonly present to orthodontists with complaints of facial and/or mandibular asymmetry. It is important that all asymmetry complaints are taken seriously and further investigated. Orthodontists play an important role in the diagnosis, management and follow-up of these conditions.
For condylar hyperactivity, management is generally in a multidisciplinary setting. Clinicians who practice orthodontics in a primary care setting need to be aware of the correct terminology and the appropriate investigations required for diagnosis and the management of this condition. This paper aims to describe the contemporary management of condylar hyperactivity and presents a case of combined orthodontic-surgical treatment.
CPD/Clinical Relevance: Condylar hyperactivity can lead to severe orofacial deformities and severe malocclusions. The orthodontist must understand the terminology, diagnostic techniques and treatment of this condition in order to offer the most appropriate management. The entire dental team may be involved in cases of condylar hyperactivity from diagnosis through to follow-up. Increased awareness may therefore improve diagnosis and ensure appropriate early referrals are made, thus potentially improving outcomes.
Article
Condylar Hyperactivity (CH) is a rare, self-limiting, pathological bone enlargement of the mandible.1 Three distinct types of CH exist:2 Hemimandibular Elongation (HE) represents the enlargement of one half of the mandible in the sagittal plane; Hemimandibular Hyperplasia (HH) is the enlargement of the mandible in the sagittal, vertical and transverse planes2 and the third subtype (Hybrid), is a combination of features of excessive hemimandibular mass (HH) and length (HE).3
The Hybrid phenotype represents 2% of all patients diagnosed with CH and is an uncommon presentation. Symptoms first present between the ages of 13−15 years, however, CH can develop at any age.1 Females are more likely to be affected than males. In addition, it has been proposed that the onset of symptoms are linked to the commencement of puberty, therefore symptoms generally present earlier in females.1,4
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