Treatment of hemimandibular hyperplasia: The biological basis of condylectomy

Treatments to correct skeletal deformities in patients with hemimandibular hyperplasia differ, particularly about the age at which the operation is done and the operation itself. To some extent, the differences can be attributed to the unknown biological basis of disease. The aim of the present study was to evaluate clinically the outcome of a rationale for the operation based on condylectomy on the affected side. Histological, radiological, and nuclear methods were used to get a more detailed insight into the reason for the operation. Six patients with hemimandibular hyperplasia were treated by a combined orthodontic-maxillofacial protocol. All patients had the affected joint removed. The histological morphology of each condylar specimen was compared with the bone scintigraphy to try and find a correlation between the methods. The clinical evaluation showed morphological and functional rehabilitation of all six patients. During the 2-year follow-up, all patients had stable symmetrical mandibles with no disturbance of temporomandibular function. Remodelling of the joint and the destruction of the cartilaginous layer was accompanied by much bone scintigraphic activity. We conclude that condylectomy can correct hemimandibular hyperplasia, even in patients with active condylar growth, by removing the underlying disease.