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Surgical approach and orthodontic treatment of mandibular condylar osteochondroma

Korean Journal of Orthodontics 2020년 50권 3호 p.206 ~ 215
Yang So-Jin, Chung Nam-Hyung, Kim Jong-Ghee, 전영미,
소속 상세정보
 ( Yang So-Jin ) - Chonbuk National University School of Dentistry Department of Orthodontics
 ( Chung Nam-Hyung ) - Chonbuk National University School of Dentistry Department of Orthodontics
 ( Kim Jong-Ghee ) - Chonbuk National University School of Dentistry Department of Orthodontics
전영미 ( Jeon Young-Mi ) - Chonbuk National University School of Dentistry Department of Orthodontics

Abstract


Osteochondroma is a common benign tumor of bones, but it is rare in the mandibular condyle. With its outgrowth it manifests clinically as deviation of the mandible limitation of mouth opening, and facial asymmetry. After the tumor is diagnosed on the basis of clinical symptoms and radiographic examination including cone-beam computed tomography (CBCT) analysis, an appropriate surgery and treatment plan should be formulated. Herein, we present the case of a 44-year-old female patient who visited our dental hospital because her chin point had been deviating to the left side slowly but progressively over the last 3 years and she had difficulty masticating. Based on CBCT, she was diagnosed with skeletal Class III malocclusion accompanied by osteochondroma of the right mandibular condyle. Maxillary occlusal cant with the right side down was observed, but it was confirmed to be an extrusion of the molars associated with dental compensation. Therefore, after intrusion of the right molars with the use of temporary anchorage devices, sagittal split ramus osteotomy was used to remove the tumor and perform orthognathic surgery simultaneously. During 6 months after the surgery, continuous bone resorption and remodeling were observed in the condyle of the affected side, which led to a change in occlusion. During the postoperative orthodontic treatment, intrusive force and buccal torque were applied to the molars on the affected side, and a proper buccal overjet was created. After 18 months, CBCT revealed that the rate of bone absorption was continuously reduced, bone corticalization appeared, and good occlusion and a satisfying facial profile were achieved.

키워드

Osteochondroma; Condyle remodeling

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