[Condylar hyperplasia: qualitative and quantitative study of temporomandibular joints remodeling before and after condylectomy].

Orthod Fr

Département Universitaire de Chirurgie Maxillo-Faciale et Stomatologie, Hôpital Roger Salengro, CHU, rue du Pr Émile Laine, 59000 Lille, France - Université Lille Nord de France, UDSL, 59000 Lille, France - Unité INSERM U1008, Médicaments et Biomatériaux à Libération Contrôlée, 59000 Lille, France - Association Internationale de Médecine Orale et Maxillo-Faciale (AIMOM), 7 bis rue de la créativité, 59650 Villeneuve-d'Ascq, France.

Published: June 2014

Purpose: This retrospective study aimed to evaluate bone remodeling of temporo-mandibular joints (TMJ) using computed tomography (CT) before and after condylectomy for condylar hyperplasia.

Material And Method: TMJ bone remodeling was studied by comparing the pre and postoperative CT scan of ten patients. Qualitative evaluation was performed by two-dimensional analysis. Three-dimensional analysis superimpositions were done after digital condylar units isolation. Condylar volume modifications were measured and compared on both sides. Lastly, before and after surgery, we studied the radio-clinic correlations.

Results: After surgery, all the operated condyles developed a new cortical bone. We noticed also a thickening of the glenoid fossa. Surgical condylectomy leaded to a 43.5% volume reduction on the operated side and 2.14% on the controlateral side. On the controlateral side, most of abnormalities seen preoperatively disappeared after surgery. For two patients, the condylar resection took away over 80% of the initial volume. For these patients, we observed major radiologic modifications on the controlateral TMJ associated with symptoms of dysfunction. These problems did not worsen their quality of life.

Conclusion: Both TMJ presented with bone remodelling after condylectomy. In condylar hyperplasia, condylectomy provides orthopaedic results on dysmorphia and removal of the pathological prechondroblastic zone. In the future, an earlier detection of this pathology may help the surgeon to treat in childhood. This would limit surgical excision and would avoid important dysmorphia.

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http://dx.doi.org/10.1051/orthodfr/2014006DOI Listing

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