World Journal of Dentistry

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VOLUME 11 , ISSUE 2 ( March-April, 2020 ) > List of Articles

CASE REPORT

Orthognathic Surgery for Correction of Facial Asymmetry after Condylar Fracture Using Computer Virtual Planning: A Case Report

Mohammed Nadershah

Keywords : Condylar fracture, Orthognathic surgery, Post-traumatic malocclusion, Virtual planning

Citation Information : Nadershah M. Orthognathic Surgery for Correction of Facial Asymmetry after Condylar Fracture Using Computer Virtual Planning: A Case Report. World J Dent 2020; 11 (2):156-160.

DOI: 10.5005/jp-journals-10015-1716

License: CC BY-NC 4.0

Published Online: 18-07-2020

Copyright Statement:  Copyright © 2020; The Author(s).


Abstract

Aim: This case report illustrates the management of post-traumatic malocclusion resulting from a condylar fracture during childhood using orthognathic surgery and three-dimensional virtual computer planning. Background: Condylar fractures during childhood can result in severe functional and esthetic problems. The temporomandibular joint (TMJ) is the foundation for orthognathic surgery. The management of this complex dentofacial deformity represents a challenge to the oral and maxillofacial surgeon. Case description: A 40-year-old man with a history of childhood trauma resulting in right sub-condylar fracture presented with severe facial asymmetry, canting of the occlusal plane, obstructive sleep apnea (OSA) symptoms, and limitation of his mouth opening. He underwent minimal presurgical orthodontics followed by orthognathic surgery including a LeFort 1 osteotomy, bilateral sagittal split osteotomy, and genioplasty. The occlusal plane was corrected by the counterclockwise rotation of the maxillomandibular complex (CCRMMC). A computer virtual planning facilitated the three-dimensional correction of this complex dentofacial deformity. It was possible to achieve the planned surgical movements despite difficulty in seating the condyle in the injured side. Conclusion: Post-traumatic malocclusion resulting from a condylar fracture during childhood was managed by orthognathic surgery without TMJ surgery. Clinical significance: Three-dimensional computer planning is a valuable aid in planning orthognathic surgery especially for facial asymmetry. Condylar seating during mandibular osteotomy is challenging even after years from condylar fracture. Temporomandibular joint surgery is not a necessity prior to orthognathic surgery in these cases if the patient has an acceptable mouth opening. The CCRMMC facilitated improvement in profile and OSA symptoms.


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