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.

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Eve, May 15th, 1. Condylar hyperplasia can be considered to be the end result of primary cartilage formation and secondary bone replacement. No subluxation, TMJ pain, or dysfunction is observed. None, Conflict of Interest: Fig 2d Patient’s preoperative dental occlusion showing an oblique occlusal plane, a right open bite, and a centered dental midline.

Hemimandibular hyperplasia treated by early high condylectomy: Histologically, byperplasia hyperactive growth includes the whole fibrocartilaginous layer.

Fig 2g Postoperative dental occlusion 3 years after surgery. The hyperplastic side usually involves the condyle, condylar neck, ramus, and body, with the anomaly terminating abruptly at the symphysis. Fig 1c The preoperative panoramic radiograph reveals a discrepancy in size and morphology between the right and left condyles, enlargement of the right condyle, and elongation of the right ascending ramus.

Condylar hyperplasia

Journal of Maxillofacial Surgery. Hugo Obwegeser et al. Generally, the abnormal growth of the mandible ceases at the same time as the completion of general growth. The patient’s parents declined postoperative orthodontic therapy to correct the deep bite.

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. By using this site, you agree to the Terms of Use and Privacy Policy.


Hemimandibular hyperplasia: classification and treatment algorithm revisited.

Accordingly, surgical treatments are designed respectively on the basis of the authors’ classification and treatment algorithm. Few reports are available regarding the long-term follow-up of patients affected by HH who have undergone early high condylectomy.

The dental occlusion showed a Class II division 2 malocclusion deep biteand the dental midline was centered Fig 1b. The explanations are demonstrated by the illustrations of some cases.

Hemimandibular hyperplasia is a developmental asymmetry characterized by three-dimensional enlargement of half of the mandible.

Hemimandibular hyperplasia: classification and treatment algorithm revisited.

The facial appearance and symmetry are quite good. Fig 1a Patient’s preoperative frontal view showing the evident facial asymmetry. An early high condylectomy was performed.

Diagnosis of asymmetry can be done through many different methods. An open bite and a crossbite might be present on the affected side, while in HH a crossbite is almost never present. In such a case, orthognathic surgery would be much more extensive, usually involving the maxilla, the mandible, the chin, the lower border of the mandible, and, sometimes, the condyle as well Figs 2e to 2h. Several theories exist in literature which related to the cause of condylar hyperplasia.

Hugo Obwegesr and Makek classified condylar hyperplasia into three categories, listed in the table below. The pathophysiological bases of the abnormal growth are discussed.

These anomalies can be clinically present in a pure form or in combination. Facial profile Click here to view.

There are two basically different malformations of one side of the mandible which we call hemimandibular hyperplasia and hemimandibular elongation respectively. It appears to arise as an acceleration of growth in younger patients, perhaps triggered by the metabolic events during the adolescent growth spurt, or as a prolongation of growth in older individuals caused by one side continuing to grow beyond the mids, an age at which growth should have ceased.


Separation and characterization of the cellular elements”. Hemimandibular elongation, hemimandibular hyperplasia, facial asymmetry.

Severe facial asymmetry is evident.

Clinical and radiographic experience as well as histological findings leave no doubt that the term “condylar hyperplasia” refers only to hyperplasia of the condyle alone and should therefore not be used to mean the two hemimandibular anomalies as is the case in the literature today.

Hemimandibular hyperplasia was clearly described hyperplaxia Obwegeser and Makek 2 and must be distinguished from solitary and exclusive hyperplasia of the condyle.

Bone scanning, hemimwndibular tracer method based on the injection of phosphates labeled with a radionuclide, is a noninvasive technique to evaluate whether the condylar growth is still active. The etiologic factors that cause facial asymmetries and their underlying mechanisms are not yet completely understood.

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 hyperpoasia growth with a single condylectomy. Fig 2h right Postoperative view of the patient 3 years after surgery. Clinical examination revealed significant facial asymmetry, deviation of the chin to the left side, and an increase in the vertical height of the middle and lower facial thirds on the right side Fig 1a.