Equipo Editorial Ovidental
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Unilateral condylar hyperactivity (UCH) is a rare condition characterized by excessive growth activity in one of the mandibular condyles, leading to progressive facial asymmetry and dental malocclusion.
First described by Adams in 1936, UCH presents diagnostic challenges due to its uncommon occurrence and the subtlety of early symptoms.
Patients typically exhibit chin deviation, dental midline discrepancies, and unilateral crossbite, among other clinical signs.
Advanced imaging techniques, such as single-photon emission computed tomography (SPECT), are instrumental in assessing condylar activity and guiding treatment planning.
Recent studies have emphasized the importance of early diagnosis and intervention in managing UCH.
High condylectomy, often combined with orthodontic treatment, has been shown to effectively halt abnormal growth and improve facial symmetry.
In a clinical series involving 49 patients aged 10 to 45, high condylectomy followed by orthodontic therapy resulted in satisfactory outcomes, with only a subset requiring secondary surgical procedures for optimal aesthetic and functional results.
Recent Advances in Treatment
High condylectomy, which involves the surgical removal of the active growth center of the affected condyle, has been a standard treatment for UCH.
Recent studies have demonstrated that performing high condylectomy in adolescents, particularly before the full eruption of canines, can significantly reduce facial asymmetry and may eliminate the need for subsequent orthognathic surgery.
In a study by Olate et al., early high condylectomy resulted in a significant reduction in chin deviation, from an average of 7.55 mm preoperatively to 1.55 mm postoperatively.
Additionally, computer-guided proportional condylectomy has emerged as a precise approach, allowing for tailored resections based on individual anatomical variations. This technique enhances surgical accuracy and outcomes.
In cases where significant mandibular asymmetry persists post-condylectomy, orthognathic surgery may be indicated to restore facial symmetry and proper occlusion.
The combination of high condylectomy and orthognathic procedures has been shown to effectively address both the hyperactive growth and its resultant deformities.
Conclusion
Advancements in surgical techniques, particularly early high condylectomy and computer-guided proportional condylectomy, have improved the management of unilateral condylar hyperactivity.
Early intervention is essential to achieve optimal functional and aesthetic outcomes, reducing the need for more extensive surgical procedures later in life.
