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Nonsyndromic Facial Asymmetry with Unilateral Condylar Aplasia

DOI: 10.1155/2013/631284

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Abstract:

Introduction. The temporomandibular joint (TMJ) is the most complex elegantly designed joint in the human body. Abnormal development and growth of TMJ may lead to condyle aplasia present in several syndromes expressions, but it is extremely rare when not connected to any underlying pathological disorder or in conjunction with any syndrome. Objective. A rare case of aplasia of the mandibular condyle is presented, along with 3D computed tomography (3D CT) findings. Conclusion. Based on clinical and radiological findings we suggest the abnormal development of the TMJ as the origin. The 3D CT has provided high-quality images, which made diagnosis and a prompt treatment plan possible. 1. Introduction The temporomandibular joint (TMJ) is the most complex elegantly designed joint in the human body [1]. It is a ginglymoarthrodial joint, a term that is derived from ginglymus, meaning a hinge joint, allowing motion only backward and forward in one plane, and arthrodia, meaning a joint which permits a gliding motion of the surfaces [2]. The right and left TMJ form a bicondylar articulation and ellipsoid variety of the synovial joints similar to knee articulation [3]. The most important functions of the TMJ are mastication and speech and are of great interest to dentists, orthodontists, clinicians, and radiologists. This interest stems from the standpoints of structure, function, adaptability, symptomatology, pathology, and imaging [4]. TMJ develops from separate temporal and condylar bronchial arches that grow towards each other at eighth week of fetal stage, with the ossification process starting at tenth week. The TMJ initial functions start at twentieth week during the fetal stage, when mouth opening movements appears it is before the development of the definitive joint. The development process will not be complete until twelfth year of life [5]. Varying degrees of condylar hypoplasia, from minimal to complete absence named as condylar aplasia, may occur due to abnormal development and growth of TMJ [5]. The most common causes of condyle alterations are inflammatory process in the area, rheumatoid arthritis, and radiotherapy [6]. The parathyroid hormone-related protein also affects the bone formation and chondrocyte differentiation and, consequently, the condyle formation [7, 8]. We are presenting a rare case of aplasia of the mandibular condyle, along with 3D computed tomography (3D CT) findings. 2. Case Report A 10-year-old female presented with a chief complaint of asymmetry of left half of the face, which was first noticed during early childhood and had

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