Condylar hypoplasia explained

Condylar hypoplasia is known as underdevelopment of the mandibular condyle. Congenitally (primary) caused condylar hypoplasia leads to underdeveloped condyle at birth.^[1] Hypoplasia of mandible can be diagnosed during birth, in comparison to the hyperplasia which is only diagnosed later in growth of an individual.

Types

Congenital (primary)

Congenital condylar hypoplasia happens when a person is born with smaller condyle than normal. The small condyle can be present either one or both sides of the lower jaw. This type of condition usually happens as part of systemic diseases such as Hemifacial microsomia, Mandibulofacial Dysostosis, Goldenhar syndrome, Hurler syndrome, Proteus syndrome and Morquio syndrome.^{[2] [3] [4]}

Acquired (secondary)

Acquired condylar hypoplasia happens when a person is not born with a small condyle but they sustain an injury during their growth which leads to this condition. The injury causes stop of growth in the condyle, resulting in a smaller condyle. The type of injuries that can happen are most traumatic in nature. Injury or infection related to ear, childhood rheumatoid arthritis and parathyroid hormone related deficiency are known to cause the injury.^{[5] [6]}

Presentation

Individuals with condylar hypoplasia may present with small mandible, symmetry in lower jaw and increased overjet. Depending on the presence or absence of the condyle, an individual may have limited opening of the mouth.

Treatment

Treatment of this condyle usually requires a multi-team approach involving an oral surgeon, an orthodontist and a plastic surgeon. A treatment usually involves some type of bone graft from one's own body to their low jaw. A costochondral bone graft has been successfully used to add bone to the mandible by oral and plastic surgeons.^[7] This type of graft can be lengthened by a procedure known as distraction osteogenesis which adds bone to the already placed graft. The graft is usually placed before the growth spurt occurs in an individual. The graft placement is later followed by an orthognathic surgery after the growth has finished in an individual.

See also

• Condylar hyperplasia
• Craniofacial team
• Distraction osteogenesis
• Hemifacial microsomia

Notes and References

1. Shivhare. Peeyush. Shankarnarayan. Lata. Usha. null. Kumar. Mahesh. Sowbhagya. Malliger Basavaraju. 2013. Condylar aplasia and hypoplasia: a rare case. Case Reports in Dentistry. 2013. 745602. 10.1155/2013/745602. 2090-6447. 3619622. 23634308. free .
2. Kaneyama. Keiseki. Segami. Natsuki. Hatta. Toshihisa. September 2008. Congenital deformities and developmental abnormalities of the mandibular condyle in the temporomandibular joint. Congenital Anomalies. 48. 3. 118–125. 10.1111/j.1741-4520.2008.00191.x. 0914-3505. 18778456. free.
3. DeLone. D. R.. Brown. W. D.. Gentry. L. R.. November 1999. Proteus syndrome: craniofacial and cerebral MRI. Neuroradiology. 41. 11. 840–843. 10.1007/s002340050853. 10602859. 23002970 . 0028-3940.
4. Ozturk. Sendar. Sengezer. Mustafa. Isik. Selcuk. Gul. Davut. May 2005. The Correction of Auricular and Mandibular Deformities in Auriculo-Condylar Syndrome. Journal of Craniofacial Surgery. 16. 3. 489–492. 10.1097/01.SCS.0000147655.94656.0D. 15915123. 1049-2275.
5. Canger. E M. Çelenk. P. March 2012. Aplasia of the mandibular condyle associated with some orthopaedic abnormalities. Dentomaxillofacial Radiology. 41. 3. 259–263. 10.1259/dmfr/93380292. 0250-832X. 3520292. 22116127.
6. Santos. K. C. P.. Dutra. M. E. P.. Costa. C.. Lascala. C. A.. Lascala. C. E.. de Oliveira. J. X.. October 2007. Aplasia of the mandibular condyle. Dento Maxillo Facial Radiology. 36. 7. 420–422. 10.1259/dmfr/23852698. 0250-832X. 17881603. 8779977 .
7. Stelnicki. Eric J.. Hollier. Larry. Lee. Catherine. Lin. Wen-Yuan. Grayson. Barry. McCarthy. Joseph G.. March 2002. Distraction osteogenesis of costochondral bone grafts in the mandible. Plastic and Reconstructive Surgery. 109. 3. 925–933; discussion 934–935. 0032-1052. 11884810. 10.1097/00006534-200203000-00017. 22551598 .