Osteochondroma of the mandibular condyle: surgical excision followed by occlusal stabilization

J Craniofac Surg. 2012 Mar;23(2):480-5. doi: 10.1097/SCS.0b013e3182413f32.

Abstract

Osteochondroma of the mandibular condyle in adults can be treated by surgical excision, condylectomy followed by costochondral graft or orthognathic surgery. Such complex treatment plan may not be appropriate for patients with old age, affected with chronic osteochondroma of the condyle. In this clinical report, we present a patient with osteochondroma of the condyle treated by surgical excision. The patient's postoperative occlusion was a contraindication for orthognathic surgery because of the severe abrasion of the teeth and the chronic compensation of the dentition to the deviated mandible. Surgical excision of the lesion was carried out under general anesthesia, and the remaining condylar head was salvaged as much as possible. No graft materials or posthodontic condyle reconstruction was carried out. Because there was no occlusal stop to secure the mandible in a centric relation position of the condyle, a stabilization splint was delivered to position the condyle in a relatively stable position. The stability of the condyle position was evaluated by follow-up cone beam computed tomographic scans of the pathologic and the contralateral condyle, along with clinical factors such as occlusal contact points and mandible movements assayed by ARCUSdigma (KaVo). After significant condylar position was achieved, full prosthodontic reconstruction was performed to both the patient's and the dentist's satisfaction.

Publication types

  • Case Reports

MeSH terms

  • Cone-Beam Computed Tomography
  • Disease Progression
  • Facial Asymmetry / diagnostic imaging
  • Facial Asymmetry / surgery
  • Humans
  • Joint Dislocations / diagnostic imaging
  • Joint Dislocations / surgery
  • Male
  • Malocclusion / diagnostic imaging
  • Malocclusion / surgery*
  • Mandibular Neoplasms / diagnostic imaging
  • Mandibular Neoplasms / surgery*
  • Middle Aged
  • Orthodontics, Corrective
  • Orthognathic Surgical Procedures
  • Osteochondroma / diagnostic imaging
  • Osteochondroma / surgery*
  • Radiography, Panoramic
  • Trismus / diagnostic imaging
  • Trismus / surgery
  • Vertical Dimension