Proportional condylectomy and orthodontic treatment with aligners in unilateral condylar hyperplasia: an observational study

Background: Unilateral Condylar Hyperplasia (UCH) is a pathology characterized by an excessive growth of a mandibular condyle. Nitzan et al. create a classification system based on clinical criteria, dividing condylar hyperplasia into vertical, transverse and combined forms. The Authors present a retrospective study of 14 patients treated with proportional condylectomy, functional arthroplasty (Iannetti et Cascone 1989) and aligners technique. Objectives: This study wants to investigate the advantages of proportional condylectomy and aligners as sole technique to treat Unilateral Condylar Hyperplasia Methods: A retrospective study was conducted on patients with UCH treated from 2013 to 2017. UCH had been diagnosed by clinical, radiographic and scintigraphy examination. Series of extra-oral, intra-oral and occlusal photographs were taken before the surgery (T0), at the end of the main phase of the orthodontic treatment (T1) and at the end of the refinement part of the orthodontic treatment (T2). CBCTs were requested at T0 and T2 timepoint. Furthermore, a positive Single Positron Emission Computed Tomography (SPECT) more than 10% between left and right condylar uptake was required. Proportional condilectomy was the surgical treatment of choice. All patients were treated by the same surgeon (P.C.) and the same orthodontist (D.C.). Findings: Six patients, who had reached occlusion stability and a good TMJ function after the main phase, had an average period of 9.6 months to complete the refinement phase with a mean of 15,8 aligners to correct remaining occlusal problems. 71.4% of patients improved chin deviation while all patients reached the central midline position, correcting cross and open bite. Conclusion: Data collected from 14 patients’ sample, demonstrate efficacy of proportional condilectomy and aligners treatment instead of orthognathic surgery and “traditional” orthodonthics.