 | This article may be too technical for most readers to understand.(November 2017) |
| Condylar hypoplasia |
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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.
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 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. [1] [5] [6]
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.
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Treatment of this condyle usually requires a multi-team approach involving an oral surgeon, an orthodontist and a plastic surgeon. [5] 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.
In anatomy, the temporomandibular joints (TMJ) are the two joints connecting the jawbone to the skull. It is a bilateral synovial articulation between the temporal bone of the skull above and the mandible below; it is from these bones that its name is derived. This joint is unique in that it is a bilateral joint that functions as one unit. Since the TMJ is connected to the mandible, the right and left joints must function together and therefore are not independent of each other.
Treacher Collins syndrome (TCS) is a genetic disorder characterized by deformities of the ears, eyes, cheekbones, and chin. The degree to which a person is affected, however, may vary from mild to severe. Complications may include breathing problems, problems seeing, cleft palate, and hearing loss. Those affected generally have normal intelligence.
Orthognathic surgery, also known as corrective jaw surgery or simply jaw surgery, is surgery designed to correct conditions of the jaw and lower face related to structure, growth, airway issues including sleep apnea, TMJ disorders, malocclusion problems primarily arising from skeletal disharmonies, other orthodontic dental bite problems that cannot be easily treated with braces, as well as the broad range of facial imbalances, disharmonies, asymmetries and malproportions where correction can be considered to improve facial aesthetics and self esteem.
Hemifacial microsomia (HFM) is a congenital disorder that affects the development of the lower half of the face, most commonly the ears, the mouth and the mandible. It usually occurs on one side of the face, but both sides are sometimes affected. If severe, it may result in difficulties in breathing due to obstruction of the trachea—sometimes even requiring a tracheotomy. With an incidence in the range of 1:3500 to 1:4500, it is the second most common birth defect of the face, after cleft lip and cleft palate. HFM shares many similarities with Treacher Collins syndrome.
Distraction osteogenesis (DO), also called callus distraction, callotasis and osteodistraction, is a process used in orthopedic surgery, podiatric surgery, and oral and maxillofacial surgery to repair skeletal deformities and in reconstructive surgery. The procedure involves cutting and slowly separating bone, allowing the bone healing process to fill in the gap.
Goldenhar syndrome is a rare congenital defect characterized by incomplete development of the ear, nose, soft palate, lip and mandible on usually one side of the body. Common clinical manifestations include limbal dermoids, preauricular skin tags and strabismus. It is associated with anomalous development of the first branchial arch and second branchial arch.
The condyloid process or condylar process is the process on the human and other mammalian species' mandibles that ends in a condyle, the mandibular condyle. It is thicker than the coronoid process of the mandible and consists of two portions: the condyle and the constricted portion which supports it, the neck.
The mandibular fossa, also known as the glenoid fossa in some dental literature, is the depression in the temporal bone that articulates with the mandible.
Pierre Robin sequence is a congenital defect observed in humans which is characterized by facial abnormalities. The three main features are micrognathia, which causes glossoptosis, which in turn causes breathing problems due to obstruction of the upper airway. A wide, U-shaped cleft palate is commonly also present. PRS is not merely a syndrome, but rather it is a sequence—a series of specific developmental malformations which can be attributed to a single cause.
Hearing loss with craniofacial syndromes is a common occurrence. Many of these multianomaly disorders involve structural malformations of the outer or middle ear, making a significant hearing loss highly likely.
Micrognathism is a condition where the jaw is undersized. It is also sometimes called mandibular hypoplasia. It is common in infants, but is usually self-corrected during growth, due to the jaws' increasing in size. It may be a cause of abnormal tooth alignment and in severe cases can hamper feeding. It can also, both in adults and children, make intubation difficult, either during anesthesia or in emergency situations.
Mandibular fracture, also known as fracture of the jaw, is a break through the mandibular bone. In about 60% of cases the break occurs in two places. It may result in a decreased ability to fully open the mouth. Often the teeth will not feel properly aligned or there may be bleeding of the gums. Mandibular fractures occur most commonly among males in their 30s.
A jaw abnormality is a disorder in the formation, shape and/or size of the jaw. In general abnormalities arise within the jaw when there is a disturbance or fault in the fusion of the mandibular processes. The mandible in particular has the most differential typical growth anomalies than any other bone in the human skeleton. This is due to variants in the complex symmetrical growth pattern which formulates the mandible.
Dislocations occur when two bones that originally met at the joint detach. Dislocations should not be confused with Subluxation. Subluxation is when the joint is still partially attached to the bone.
A facial cleft is an opening or gap in the face, or a malformation of a part of the face. Facial clefts is a collective term for all sorts of clefts. All structures like bone, soft tissue, skin etc. can be affected. Facial clefts are extremely rare congenital anomalies. There are many variations of a type of clefting and classifications are needed to describe and classify all types of clefting. Facial clefts hardly ever occur isolated; most of the time there is an overlap of adjacent facial clefts.
Condylar resorption, also called idiopathic condylar resorption, ICR, and condylysis, is a temporomandibular joint disorder in which one or both of the mandibular condyles are broken down in a bone resorption process. This disorder is nine times more likely to be present in females than males, and is more common among teenagers.
The development of craniofacial growth is a complicated phenomenon that has been the subject of much research for past 70 years. From the first theory in 1940s, many different ideas pertaining to how a face develops has intrigued the minds of researchers and clinicians alike.
Condylar hyperplasia is over-enlargement of the mandible bone in the skull. It was first described by Robert Adams in 1836 who related it to the overdevelopment of mandible. In humans, mandibular bone has two condyles which are known as growth centers of the mandible. When growth at the condyle exceeds its normal time span, it is referred to as condylar hyperplasia. The most common form of condylar hyperplasia is unilateral condylar hyperplasia where one condyle overgrows the other condyle leading to facial asymmetry. Hugo Obwegeser et al. classified condylar hyperplasia into two categories: hemimandibular hyperplasia and hemimandibular elongation. It is estimated that about 30% of people with facial asymmetry express condylar hyperplasia.
Craniofacial regeneration refers to the biological process by which the skull and face regrow to heal an injury. This page covers birth defects and injuries related to the craniofacial region, the mechanisms behind the regeneration, the medical application of these processes, and the scientific research conducted on this specific regeneration. This regeneration is not to be confused with tooth regeneration. Craniofacial regrowth is broadly related to the mechanisms of general bone healing.
Andrew A.C. Heggie is an oral and maxillofacial surgeon at the Royal Children's Hospital in Melbourne, Australia. His primary interest has been the management of developmental skeletal facial deformity, including patients with cleft lip and palate, craniofacial microsomia and infants with micrognathism. His contribution to the treatment of infant upper airway obstruction for Pierre Robin sequence, using internal devices for jaw lengthening using distraction osteogenesis, has replaced the need for tracheostomy in this condition. In 2019, Heggie was awarded Member of the Order of Australia for significant service to medicine and dentistry in the field of oral and maxillofacial surgery.