Sammanfattning
Introduction and purpose – Hemimandibular hyperplasia (HH)
is a developmental unilateral three-dimensional enlargement of
the mandible resulting in distortion of the mandible with occlusal,
functional and aesthetic problems. HH typically becomes apparent
in puberty.
The treatment depends on the growth activity. Ongoing growth
activity can be detected with a bone scintigraphy, and treatment
and observation with an occlusal splint. In order to treat
the dentofacial deformity both the maxilla and the mandible often
need to be corrected, because the maxillary growth compensates
for the mandibular growth deviation.
The purpose of this article is to elucidate the aetiology, incidence
and treatment of hemimandibular hyperplasia. As a supplement,
a presentation of a group of patients treated in the Department
of Oral and Maxillofacial surgery, Aarhus University Hospital, Denmark,
is included.
Material and methods – 26 patients with hemimandibular hyperplasia
or hemimandibular elongation in treatment at the Department
of Oral and Maxillofacial Surgery, Aarhus University
Hospital, Denmark, were reviewed. Radiographic analysis and
patient records were evaluated and related to the literature.
Results and conclusions – Hemimandibular hyperplasia should
be diagnosed as early as possible in order to assess abnormal
growth activity and growth pattern and determine the optimal
time for treatment. Compensatory growth and dentoalveolar alterations
should be minimized and high condylectomy considered
in cases with active growth. Two-jaw surgery is needed
to correct deformities of the mandible and maxilla. Stability of
the orthognathic surgical treatment is difficult to predict because
hyperactive growth may recur after high condylectomy and orthognathic
surgery. The aetiology is unknown, though genetic
determinants, trauma and infection are discussed as possible
factors.