In a patient with lower third face asymmetry, malocclusion and diagnosis of activity/non activity of a condyle, which could be your approach?
HI
The proportional condylectomy can be used as the sole surgical treatment in cases of UCH, thus avoiding the need for secondary orthognathic surgery.
Condylectomy and swinging the mandible back into occlusion can be done for cases where there is not concomitant canting of maxillary occlusion. Definite surgical procedure should undergo after radionuclide scanning of condylar growth activity and confirming recession of growth. Long standing Cases with maxillary canting and crossbite need to be treated with condylotomy along with orthognathic correction of maxillary canting with segmental or lefort I osteotomy and/or BSSO for mandibular symmetry correction.
In my department we always perform a proportional condylectomy:
- avoid relapses (it’s an overgrowth disease)
- 3D remodelling of the mandible
Of course, if your maxilla is tilted, you need a Le Fort1. Even if is there an excess in the sagittal component of the ramus, you need a BSSO.
A study is yet to come, let’s keep in touch
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