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VOLUME 19 , ISSUE 4 ( 2018 ) > List of Articles

CASE REPORT

Bilateral Condylar Hyperplasia—Nonsurgical Management: A Clinical Report

Michael G Botelho, Edward HT Ho, Adrian Seto, Nithya Jagannathan

Keywords : Bone scintigraphy, Condylar hyperplasia, Open bite, Overlay denture

Citation Information : Botelho MG, Ho EH, Seto A, Jagannathan N. Bilateral Condylar Hyperplasia—Nonsurgical Management: A Clinical Report. J Contemp Dent Pract 2018; 19 (4):463-467.

DOI: 10.5005/jp-journals-10024-2284

License: CC BY-NC 3.0

Published Online: 01-01-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

Background: Patients present with malocclusions in the form of bilateral open bite with functional and esthetic challenges. These are particularly so whereby these are acquired through growth anomalies that create a change in the occlusal status whereby a patient has to adapt to the challenge of the occlusal change. While surgical intervention is a considered option to correct such changes, not all patients are willing to endure the consequences of this intervention and as such this report presents a conservative minimally invasive approach. Aim: This clinical report demonstrates a nonsurgical approach in the management of a patient with bilateral metabolically active condylar hyperplasia. Case report: The patient presented with a bilateral open bite with occlusal contacts only present on her second molars. The severity of the open bite was reported to be recently progressing and getting worse. This condition had impaired her chewing function and quality of life over an 8-year period. Bone scintigraphy was performed and metabolically active bilateral condylar hyperplasia was diagnosed. The patient refused surgical intervention and instead a conservative overlay denture was prescribed, which successfully restored her function and esthetics. Conclusion: Removable overlay dentures can be a relatively simple and effective treatment option for patients presenting with newly acquired bilateral open bites to give a functional and esthetic outcome. Clinical significance: This clinical report shows the conservative management of bilateral condylar hyperplasia with a simple removable overlay appliance. The occlusion has stabilized and the patient functions well.


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  1. Obwegeser, HL. Condylar hyperactivity. In: Obwegeser HL, editor. Mandibular growth anomalies. Berlin: Springer-Verlag; 2001. pp. 139-144.
  2. Egyedi P. Aetiology of condylar hyperplasia. Aust Dent J 1969 Feb;14(1):12-17.
  3. Deleurant Y, Zimmermann A, Peltomäki T. Hemimandibular elongation: treatment and long-term follow-up. Orthod Craniofac Res 2008 Aug;11(3):172-179.
  4. Olate S, Netto HD, Rodriguez-Chessa J, Alister JP, Albergaria- Barbosa JD, Moraes MD. Mandibular condylar hyperplasia: a review of diagnosis and treatment protocol. Int J Clin Exp Med 2013 Sep;6(9):727-737.
  5. McGarry TJ, Nimmo A, Skiba JF, Ahlstrom RH, Smith CR, Koumjian JH, Arbree NS. Classification system for partial edentulism. J Prosthodont 2002 Sep;11(3):181-193.
  6. Newberg, A. Bone scans. In: Pretorius ES, Solomon JA, editors. Radiology secrets plus. 3rd ed. Chapter 54. Philadelphia (PA): Elsevier Mosby; 2010.
  7. Harper KA, Setchell DJ. The use of shim stock to assess occlusal contacts: a laboratory study. Int J Prosthodont 2002 Jul-Aug;15(4):347-352.
  8. Robinson J, O'Brien A, Chen J, Wadhwa S. Progenitor cells of the mandibular condylar cartilage. Curr Mol Biol Rep 2015 Sep;1(3):110-114.
  9. Pereira-Santos D, De Melo WM, Souza FA, de Moura WL, Cravinhos JC. High condylectomy procedure: a valuable resource for surgical management of the mandibular condylar hyperplasia. J Craniofac Surg 2013 Jul;24(4):1451-1453.
  10. Ahn SJ, Lee SP, Nahm DS. Relationship between temporomandibular joint internal derangement and facial asymmetry in women. Am J Orthod Dentofacial Orthop 2005 Nov;128(5):583-591.
  11. Ribeiro-Dasilva MC, Peres Line SR, Leme Godoy dos Santos MC, Arthuri MT, Hou W, Fillingim RB, Rizzatti Barbosa CM. Estrogen receptor-alpha polymorphisms and predisposition to TMJ disorder. J Pain 2009 May;10(5):527-533.
  12. Mutoh Y, Ohashi Y, Uchiyama N, Terada K, Hanada K, Sasaki F. Three-dimensional analysis of condylar hyperplasia with computed tomography. J Craniomaxillofac Surg 1991 Feb;19(2):49-55.
  13. Obwegeser HL, Makek MS. Hemimandibular hyperplasia – hemimandibular elongation. J Maxillofac Surg 1986 Aug;14(4): 183-208.
  14. Wolford LM, Movahed R, Perez DE. A classification system for conditions causing condylar hyperplasia. J Oral Maxillofac Surg 2014 Mar;72(3):567-595.
  15. Posnick, JC. Asymmetric mandibular excess growth patterns. In: Posnick JC, editor. Orthognathic surgery: principles and practice. St. Louis (MO): Elsevier; 2014. pp. 807-865.
  16. Wolford LM, Morales-Ryan CA, García-Morales P, Perez D. Surgical management of mandibular condylar hyperplasia Type 1. Proc (Bayl Univ Med Cent) 2009 Oct;22(4):321-329.
  17. Laverick S, Bounds G, Wong WL. [18F]-fluoride positron emission tomography for imaging condylar hyperplasia. Br J Oral Maxillofac Surg 2009 Apr;47(3):196-199.
  18. Alyamani A, Abuzinada S. Management of patients with condylar hyperplasia: a diverse experience with 18 patients. Ann Maxillofac Surg 2012 Jan;2(1):17-23.
  19. Bouchard, C.; Lawler, M.; Kaban, LB.; Troulis, MJ. Minimally invasive orthognathic and condylar surgery. In: Guttenberg SA, editor. Cosmesis of the mouth, face and jaws. West Sussex: John Wiley & Sons, Inc.; 2013. pp. 308-317.
  20. Lippold C, Kruse-Losler B, Danesh G, Joos U, Meyer U. Treatment of hemimandibular hyperplasia: The biological basis of condylectomy. Br J Oral Maxillofac Surg 2007 Jul;45(5):353-360.
  21. Wolford LM, Mehra P, Reiche-Fischel O, Morales-Ryan CA, García-Morales P. Efficacy of high condylectomy for management of condylar hyperplasia. Am J Orthod Dentofacial Orthop 2002 Feb;121(2):136-150.
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