Cuella E, Rosemberg V, Ramayal A, Clavero D, Gilardoni A, Boyallian N

Language: Spanish
References: 15
Page: 134-138
PDF size: 1884.91 Kb.

ABSTRACT

Mandibular condylar aplasia (MCA), based on an inadequate development or absence of the mandibular condyle, is a rare anomaly. Its isolated bilateral presentation is extremely rare and challenging, affecting mandibular growth, occlusion, and joint function. Alloplastic prostheses offer a predictable and durable solution for joint reconstruction. We report the case of a 39-year-old woman, non-syndromic, with no history of trauma or infection, who consulted for facial asymmetry, severe micrognathia, and skeletal class II malocclusion with anterior open bite. The tomography revealed bilateral aplasia of the mandibular condyles, glenoid flattening, and bilateral dislocation. Polysomnography ruled out obstructive sleep apnea/hypopnea syndrome (OSAHS). Combined surgical treatment included bilateral temporomandibular joint (TMJ) replacement with customized prostheses (Raomed) and orthognathic surgery (Le Fort I, mentoplasty) for counterclockwise rotation of the maxillomandibular complex. This comprehensive approach corrected dentofacial deformities, improved mandibular projection and airway, restoring aesthetics and function. Isolated bilateral mandibular condylar aplasia in adults is very unusual. The combination of customized TMJ prostheses and orthognathic surgery is an effective strategy for anatomical and functional reconstruction and correction of dentofacial deformities, with favorable short- and medium-term results. Long-term follow-up is required to evaluate the stability of the results.

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