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比例髁突切除术治疗伴有错牙合畸形的单侧髁突增生:床旁制造手术导板和术中计算机断层扫描在避免二次正颌手术中的作用

Proportional Condylectomy for the Treatment of Unilateral Condylar Hyperplasia With Maloclussion: Role of Point-of-Care Manufacturing Surgical Guides and Intraoperative Computed Tomography to Avoid Secondary Orthognatic Surgery.

作者信息

Tousidonis Manuel, Navarro-Cuellar Carlos, Fariña Rodrigo

机构信息

Department of Oral and Maxillofacial Surgery, Hospital General Universitario Gregorio Marañon.

Instituto de Investigacion Sanitaria Gregorio Marañon, Madrid, Spain.

出版信息

J Craniofac Surg. 2025 May 1;36(3):e251-e253. doi: 10.1097/SCS.0000000000010789. Epub 2024 Oct 9.

Abstract

Condylar hyperplasia (CH) is a complex, usually unilateral pathology affecting the jaw, leading to facial asymmetry and malocclusion. Its etiology is unclear, with potential links to endocrine disorders, trauma, and genetic factors. Unilateral condylar hyperplasia (UCH) typically presents in young patients but can occur at any age. Common symptoms include progressive facial asymmetry, malocclusion, and temporomandibular joint dysfunction. Diagnostic imaging like single positron emission computed tomography helps assess condylar activity. Treatment aims to halt condylar growth and correct facial asymmetry, commonly through high condylectomy, which involves removing the upper 3 to 5 mm of the condylar head. Recently, proportional condylectomy, using point-of-care manufacturing 3-dimensional-cutting guides and intraoperative computed tomography control, has shown promising results, potentially eliminating the need for orthognathic surgery. This technique was successfully applied in a case involving a 29-year-old woman, resulting in normalized occlusion and aesthetics after subsequent orthodontic treatment, with stable outcomes 1-year post-treatment.

摘要

髁突增生(CH)是一种复杂的、通常为单侧的影响颌骨的病变,可导致面部不对称和错牙合畸形。其病因尚不清楚,可能与内分泌紊乱、创伤和遗传因素有关。单侧髁突增生(UCH)通常在年轻患者中出现,但可发生于任何年龄。常见症状包括进行性面部不对称、错牙合畸形和颞下颌关节功能障碍。像单光子发射计算机断层扫描这样的诊断成像有助于评估髁突的活动情况。治疗旨在阻止髁突生长并纠正面部不对称,通常通过高位髁突切除术进行,该手术包括切除髁突头部上方3至5毫米。最近,使用即时制造的三维切割导板和术中计算机断层扫描控制的比例髁突切除术已显示出有前景的结果,有可能无需进行正颌手术。该技术已成功应用于一名29岁女性的病例,后续正畸治疗后咬合和美观恢复正常,治疗后1年结果稳定。

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