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TMJ

(49) Surgical Treatment of Condylar Hyperplasia: One-stage vs. Two-stage Surgery

Thursday, September 21, 2023
1:30 PM – 3:00 PM PDT
Disclosure(s):
Matthew L. Beck: No financial relationships to disclose
Abstract:

Objective:
Condylar hyperplasia (CH) is a pathologic overgrowth of the mandibular condyle and can be unilateral or bilateral. Due to the limited etiological understanding of CH and limited medical options, treatment of CH is surgical. Treatment of CH depends on whether the disease is active or not. If condylar hyperplasia is still active, surgical removal of the hyperplastic condyle (high condylectomy) and orthognathic surgery to correct the bite are indicated. Orthognathic surgery without condylar surgery is not biologically stable and has a high relapse rate. The aim of this study is to compare two surgical treatments of active condylar hyperplasia in treatment time and overall patient satisfaction. One study group was submitted to high condylectomy with a second orthognathic surgery to correct the occlusal discrepancy. The other study group had both surgeries (high condylectomy and orthognathic) simultaneously.

Methods:
A retrospective study with a pool of 22 patients was carried out. All patients had active unilateral condylar hyperplasia and associated facial asymmetry. Eleven patients underwent high condylectomy with a second stage orthognathic surgery. Braces were placed on patients after high condylectomy. Orthognathic surgery was done after orthodontic alignment and decompensation were achieved.. The other eleven patients went through orthodontic treatment first. After achieving stable occlusion, surgery was done as a one stage procedure of high condylectomy and orthognathic surgery. Pain, occlusion, treatment time, and final overall treatment satisfaction of patients were evaluated.

Results:
The results showed that one stage treatment (simultaneous high condylectomy and orthognathic surgery) is a better option with regards to pain, time, and overall satisfaction.

Conclusion:
When possible, a one stage surgical treatment (high condylectomy and orthognathic surgery simultaneously) should be selected in comparison with two stage surgical treatments.