Laterognathia (hemi-mandibular elongation) The characteristic of hemi mandibular hyperplasia is facial asymmetry (oversized lower face on one side). Hemimandibular hyperplasia (HH) is a developmental asymmetry characterized by three-dimensional enla. Hemimandibular hyperplasia is a developmental asymmetry characterized by three-dimensional enlargement of half of the mandible.6 The hyperplastic side.

Author: Mizil Tygobei
Country: Uzbekistan
Language: English (Spanish)
Genre: Career
Published (Last): 17 June 2010
Pages: 18
PDF File Size: 14.91 Mb
ePub File Size: 12.80 Mb
ISBN: 315-2-73808-858-7
Downloads: 31347
Price: Free* [*Free Regsitration Required]
Uploader: Duktilar

Condylar hyperplasia

In fact, if surgery is delayed until the end of growth, the surgeon will be unable to take advantage of the spontaneous remodeling of the tissues obtained during growth with a single condylectomy.

The latter involves only the condyle, which is radiographically homogeneously enlarged, but the horizontal ramus is not increased in height and the mandibular canal is not displaced.

Condylar hyperplasia mandibular hyperplasia is over-enlargement of the mandible bone in the skull. One theory states that an event of a trauma leading to increase in number of repair mechanism and hormones in that area may lead to increase in growth of mandible on that side. Fig 2e Panoramic radiograph after extensive orthognathic surgery involving the maxilla Le Fort I osteotomythe mandible Obwegeser-Dal Pont osteotomythe chin, the lower border of the right mandible, and the condyle condylectomy.

Fig 2b The preoperative panoramic radiograph shows the great discrepancy in size and morphology between the right and left condyles, along with an enlargement of the skeletal basis of the right hemimandible in all its dimensions. Normally, the dental midline is deviated toward the unaffected side but may also be centered, depending on the vector and speed of growth.

The ascending ramus is elongated, and this is expressed by the enlargement of the condyle and the elongation and thickening of the condylar neck. The point of this surgery to wait as long as the condyle is growing and only do surgery when the condyle stops growing, so the chances of any worsening of facial asymmetry lessens.


No subluxation, TMJ pain, or dysfunction is observed. Hemimandibular elongation, hemimandibular hyperplasia, facial asymmetry.

The maximum mouth opening was 37 mm. It is important to observe that in this case, as in others described in the literature, 8,9 the pathosis also involves the maxilla with maxillary monolateral vertical growth, including the maxillary sinus. Accordingly, surgical treatments are designed respectively on the basis of the authors’ classification and treatment algorithm. Computed tomography-2 Click here to view.

Hemimandibular hyperplasia: classification and treatment algorithm revisited.

Many treatment options exist for this type of condition. How to cite this article: Fig 1g Panoramic radiograph 12 years after the condylectomy demonstrates readaptation of the right condyle in the fossa. The facial symmetry is good.

Eve, May 15th, 1 Hemimandibular hyperplasia HH is a rare malformation of non-neoplastic gyperplasia characterized by a 3-dimensional enlargement of one side of the mandible, ie, the enlargement of heminandibular condyle, the condylar neck, and the ascending and horizontal rami.

The cells are large, the cytoplasm is vesicular, and there is abundant newly produced cartilage matrix between cells.

Several theories exist in literature which related to the cause of condylar hyperplasia.

American Journal of Orthodontics and Dentofacial Orthopedics. Clinically, the facial appearance is distorted, with an increase in the height of the affected side. Condylar hyperplasia can be considered to be hemimandibhlar end result of primary cartilage formation and secondary bone replacement. In Aprila year-old boy was referred to the Department of Maxillofacial Surgery, University Hospital of Parma, complaining of temporomandibular joint TMJ discomfort and subluxation of the right condyle for almost 10 months.

Minor asymmetries of the human skeleton are common in the general population and usually have no esthetic or functional significance. Hemimandibular hyperplasia HH is a developmental asymmetry characterized by three-dimensional enlargement of one half of the mandible. They seem to contribute to the understanding of the normal and abnormal mandibular growth and consequently also of many of the mandibular anomalies.

There was a problem providing the content you requested

The facial appearance and symmetry are quite good. The panoramic radiograph demonstrates readaptation of the condyle in the fossa Fig 1g. However, in the case of condylar hyperplasia, the pathogenesis of the excessive formation of cartilage and bone still remains unknown. The hyperplastic side includes the condyle, condylar neck, ramus and corpus, and the anomaly terminates at the symphysis. It is reported that skeletal asymmetry is found even in the most pleasing and apparently symmetrical faces.


Clinical and radiographic findings were consistent with a diagnosis of right hemimandibular hyperplasia. How to cite this URL: There was no history of trauma or inflammatory disease. In the literature, genetic factors, circulatory problems, hormonal disturbances, traumatic lesions, and arthrosis have been proposed to be etiologic factors of the disease. The anomaly terminates exactly at the symphysis of the affected side, and for this reason it is called hemimandibular hyperplasia. Facial profile – right side Click here to view.

Facial profile – left side Click here to view. Fig 1f Patient’s frontal view 12 years after the operation. The surrounding anatomic structures were preserved with great care; the disc was intact and well positioned over the newly created right condyle.

AO Surgery Reference

International Hgperplasia of Clinical and Experimental Medicine. The Journal of Craniofacial Surgery. Facial profile Click here to view. The maxilla usually follows the mandible and grows downward on the affected side. An open bite and a crossbite might be present on the affected side, while in HH a crossbite is almost never present. Fig 1c The preoperative panoramic radiograph reveals a discrepancy in size and morphology between the right and left condyles, enlargement of the hemiandibular condyle, and elongation of the right ascending ramus.