Department of Oral and Maxillofacial Sciences, (Head: prof. E. Barbato), School of Dentistry, "Sapienza" University of Rome, Via Caserta, 6, 00161, Roma, RM, Italy.
J Craniomaxillofac Surg. 2018 Jul;46(7):1105-1110. doi: 10.1016/j.jcms.2018.04.028. Epub 2018 May 7.
Facial asymmetries due to unilateral condylar hyperactivity are often a challenge both for maxillo-facial surgeons and for orthodontists; the current literature shows different opinions about aetiology, classification, treatment approach and timing. We made a retrospective study on patients suffering from unilateral condylar hyperactivity between 1997 and 2015 in our Department; clinical features and treatment options were grouped and compared with literature.
The descriptive analysis investigated variables like sex, age, side and direction of the asymmetry, condylar activity and type of intervention.
The population was composed of 128 patients. The hemimandibular hyperactivity occurs equally in both sexes around the second decade, although the range of the first consultation goes from 7 to 49 y.o. The vertical hyperdevelopment group is almost equal to the horizontal. All the patients with horizontal hyperactivity showed negative scintigraphy and were treated with pre-surgical orthodontics and orthognathic surgery; patients with vertical hyperactivity and positive scintigraphy were treated with condylectomy and post-surgical orthodontics.
In our group of patients, direction of the hyperactivity and results of the scintigraphy lead to treatment choice and timing. Further studies are necessary to explain why, in our group, all the patients with horizontal involvement are negative to scintigraphy.
由于单侧髁突活动过度导致的面部不对称，无论是颌面外科医生还是正畸医生都面临着巨大挑战。目前的文献对于病因、分类、治疗方法和时机有不同的观点。我们对 1997 年至 2015 年间在我院就诊的单侧髁突活动过度患者进行了回顾性研究，对其临床特征和治疗方案进行分组，并与文献进行比较。
描述性分析调查了性别、年龄、不对称的侧别和方向、髁突活动度以及干预类型等变量。
研究人群包括 128 例患者。尽管就诊年龄范围为 7 岁至 49 岁，但男女两侧的半侧下颌骨活动过度发生的概率基本相等，在第二个十年中更为常见。垂直过度发育组与水平过度发育组基本相当。所有水平活动过度的患者均行核素扫描呈阴性，并接受术前正畸和正颌手术治疗；而垂直活动过度且核素扫描阳性的患者则接受髁突切除术和术后正畸治疗。
在我们的患者群体中，活动过度的方向和核素扫描的结果决定了治疗的选择和时机。需要进一步的研究来解释为什么在我们的患者群体中，所有水平受累的患者核素扫描均为阴性。
