Unilateral Mandible Hyperplasia: Individualized Protocols Integrating Digital Technology and Modified Techniques.

BACKGROUND

Unilateral mandibular hyperplasia (UMH) frequently results in facial asymmetry and occlusal disturbances, with no unified diagnostic or therapeutic guidelines currently available.

MATERIALS AND

METHODS

A retrospective analysis was conducted on 8 adult UMH patients, with digital technology as the core component. Preoperative virtual surgical planning (VSP) precisely determined the extent of osteotomy and condylectomy, while 3D-printed cutting guides and splints ensured accurate intraoperative execution. Single-photon emission computed tomography (SPECT) was used to assess growth activity but demonstrated limitations; therefore, a comprehensive evaluation integrating clinical history, patient age, and CT follow-up was emphasized to avoid false-positive results. All cases adhered to the one-stage surgery principle (simultaneous condylar management, orthognathic surgery, and contouring in a single procedure). Two modified surgical techniques were introduced: modified intraoral IVRO on the affected side, enabling synchronous condylectomy and joint reconstruction without facial scarring; modified SSRO on the affected side with the osteotomy line extended anterior to the mental foramen, allowing single-stage dissection and protection of the inferior alveolar nerve and facilitating contouring. Based on individual characteristics, 3 personalized protocols were proposed: condylectomy combined with orthodontics only; condylectomy combined with orthognathic surgery and contouring (for active condyles); and orthognathic surgery combined with contouring only (for inactive condyles).

RESULTS

Postoperative follow-up of all 8 patients demonstrated stable occlusion, restored facial symmetry, and no evidence of recurrence.

CONCLUSION

This study establishes a digital technology-supported personalized surgical system for UMH, enabling precise, safe, and effective restoration of facial aesthetics and function.