Ten Years of Observations and Demographics of Hemimandibular Hyperplasia and Elongation

Publication date: Available online 11 April 2018
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Kamil H. Nelke, Wojciech Pawlak, Monika Morawska-Kochman, Klaudiusz Łuczak
IntroductionThe full epidemiology and etiology of hemimandibular hyperplasia (HH) has not yet been clarified. In most cases it starts before puberty and results in various forms of dento-alveolar and skeletal discrepancies. This study is the first attempt at evaluating and describing some of the authors' key experiences, clinical philosophical approach, and gathered demographic data on hemimandibular hyperplasia and hemimandibular elongation (HE) among the Polish population.Material and methodA total of 45 patients (M=8; F=37; p<0.05) with HE (n=16; 35.6%; p<0.05), HH (n=28; 62.2%; p<0.05), or HH+HE (n=1; 2.2%; p>0.05) had been diagnosed and treated. Epidemiological, geographical, and clinical data concerning the occurrence and treatment protocols in these mandibular malformations were measured in the Polish study groups.ResultsWomen more often suffered from these mandibular malformations (82–87%). The occurrence of the first symptoms was highest at the age of 13–15 years and was statistically significant for both sides (p<0.05). The disorders were found earlier in young girls, therefore an early compensatory orthodontic treatment in some cases had been used with a limited degree of success (p>0.05). All values of bone scintigraphy were significant (p<0.001).ConclusionsA very fast growth with visible major asymmetry and enlarged condylar head should be an indication for condylectomy. Women's expectations from surgery and treatment are more demanding than men's, a fact that is connected with the predominance of females in the study group. Almost all possible treatment alternatives are not only related with the degree of skeletal deformity, but also with the patient's willingness to undergo any necessary treatment protocols, which in most cases involve more than one stage. Skeletal scintigraphy tests are an important factor in estimating bone growth and possible surgical approaches in these disorders.



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