Condylar reconstruction by oblique sliding vertical-ramus osteotomy.
BACKGROUND
The posterior border of the mandibular ramus can be used as a pedicled graft for reconstruction of the condyle. This article describes a technique that is better in certain situations than the use of other autogenous grafts or alloplastic materials.


METHODS
Three adult patients, two with osteochondroma and one with hyperplasia were treated by condylectomy and simultaneous reconstruction with the pedicled posterior mandibular border. A meticulous oblique osteotomy and reinsertion of the lateral pterygoid muscle was performed.


RESULTS
In all three cases an immediate mouth opening with stable occlusion was achieved. The interincisal opening was more than 40 mm after 3 weeks, with a deviation no greater than 4mm towards the affected side. All excursive movements were present in all directions, and correction of the facial asymmetry was achieved. There was no T.M.J. pain and all patients expressed satisfaction during the follow-up of 56 months (average). An adequate remodelling of the neocondyle without resorption as well as a stable occlusion was observed in every case.


CONCLUSIONS
Reconstruction of the condyle by sliding vertical-oblique ramus osteotomy provides, in cases of condylar tumours, excellent functional and cosmetic results.
Martinez-Lage
Juan L
JL
Department of Cranio-Maxillofacial Surgery, Hospital Ramón y Cajal, Madrid, Spain. jlmlage@hotmail.com
Gonzalez
Joaquín
J
Pineda
Alberto
A
Alvarez
Inmaculada
I
D000328:Adult; D016723:Bone Remodeling / Q000502:physiology; D005146:Facial Asymmetry / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008334:Mandible / Q000503:physiopathology / Q000601:surgery; D008335:Mandibular Condyle / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000601:surgery; D009068:Movement; D015831:Osteochondroma / Q000601:surgery; D010027:Osteotomy / Q000379:methods*; D017060:Patient Satisfaction; D011626:Pterygoid Muscles / Q000601:surgery; D013524:Surgical Flaps