Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons · 2026
Simultaneous Orthognathic Surgery and Condylectomy for Active Unilateral Condylar Hyperplasia: Indications and Outcomes of a Single-Stage Protocol.
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Fariña Rodrigo, Moreno Emilio, Lolas Jorge, Mayer Cristopher, Fariña-Silva Gabriel, Perez Daniel
Аннотация
BACKGROUND: Active unilateral condylar hyperplasia (AUCH) leads to progressive facial asymmetry and occlusal imbalance and may coexist with preexisting skeletal discrepancies. In such cases, a single-stage approach combining condylectomy and orthognathic surgery can address both pathological growth and the associated dentofacial deformity.
PURPOSE: The aim of this study was to present a treatment protocol and surgical algorithm for simultaneous orthognathic surgery and condylectomy in subjects with AUCH and to evaluate clinical outcomes in a retrospective case series.
STUDY DESIGN, SETTING, AND SAMPLE: This retrospective case series included 24 adult subjects with AUCH treated between 2012 and 2018 in Santiago, Chile. Diagnosis was based on clinical evaluation, cone beam computed tomography, and single-photon emission computed tomography demonstrating ≥55% condylar activity. All subjects had completed growth and presented AUCH associated with dentofacial deformities requiring orthognathic correction, including maxillary hypoplasia, reduced upper airway, or mandibular advancement.
PREDICTOR/EXPOSURE/INDEPENDENT VARIABLES: Not applicable.
OUTCOME VARIABLES: Primary outcomes included postoperative occlusal stability (achievement and maintenance of Class I occlusion), facial symmetry (clinical and patient-reported), temporomandibular joint symptoms, mouth opening, complications, and need for reintervention.
COVARIATES: Covariates included age, sex, follow-up duration, type of condylectomy (high or adapted), type of mandibular osteotomy, surgical sequence, and concomitant procedures, all determined through virtual surgical planning.
ANALYSES: Descriptive statistics were used to summarize subject characteristics and outcomes. No inferential analyses were performed.
RESULTS: Twenty-four subjects (mean age 20.8 ± 3.6 years; 66.7% female, 33.3% male) were included, with a median follow-up of 6 years. All subjects achieved stable Class I occlusion and satisfactory facial symmetry. No temporomandibular joint symptoms or reinterventions were observed. The mean mouth opening was 45 mm. Minor complications (transient facial paresis) occurred in 12.5% of subjects.
CONCLUSIONS AND RELEVANCE: Simultaneous orthognathic surgery and condylectomy is an effective approach for managing AUCH associated with dentofacial deformities, providing stable functional and aesthetic outcomes. Virtual surgical planning enables a structured surgical algorithm, guiding both the surgical sequence and the selection of the appropriate type of condylectomy, and may reduce the need for more invasive mandibular procedures.
PURPOSE: The aim of this study was to present a treatment protocol and surgical algorithm for simultaneous orthognathic surgery and condylectomy in subjects with AUCH and to evaluate clinical outcomes in a retrospective case series.
STUDY DESIGN, SETTING, AND SAMPLE: This retrospective case series included 24 adult subjects with AUCH treated between 2012 and 2018 in Santiago, Chile. Diagnosis was based on clinical evaluation, cone beam computed tomography, and single-photon emission computed tomography demonstrating ≥55% condylar activity. All subjects had completed growth and presented AUCH associated with dentofacial deformities requiring orthognathic correction, including maxillary hypoplasia, reduced upper airway, or mandibular advancement.
PREDICTOR/EXPOSURE/INDEPENDENT VARIABLES: Not applicable.
OUTCOME VARIABLES: Primary outcomes included postoperative occlusal stability (achievement and maintenance of Class I occlusion), facial symmetry (clinical and patient-reported), temporomandibular joint symptoms, mouth opening, complications, and need for reintervention.
COVARIATES: Covariates included age, sex, follow-up duration, type of condylectomy (high or adapted), type of mandibular osteotomy, surgical sequence, and concomitant procedures, all determined through virtual surgical planning.
ANALYSES: Descriptive statistics were used to summarize subject characteristics and outcomes. No inferential analyses were performed.
RESULTS: Twenty-four subjects (mean age 20.8 ± 3.6 years; 66.7% female, 33.3% male) were included, with a median follow-up of 6 years. All subjects achieved stable Class I occlusion and satisfactory facial symmetry. No temporomandibular joint symptoms or reinterventions were observed. The mean mouth opening was 45 mm. Minor complications (transient facial paresis) occurred in 12.5% of subjects.
CONCLUSIONS AND RELEVANCE: Simultaneous orthognathic surgery and condylectomy is an effective approach for managing AUCH associated with dentofacial deformities, providing stable functional and aesthetic outcomes. Virtual surgical planning enables a structured surgical algorithm, guiding both the surgical sequence and the selection of the appropriate type of condylectomy, and may reduce the need for more invasive mandibular procedures.