CURRENT PROBLEMS OF UNILATERAL CONDYLAR HYPERPLASIA DIAGNOSIS

At the moment, the problem of differential diagnosis between facial asymmetry cdue to unilateral condylar hypoplasia and hyperplasia, presence of condylar bone tumors, dislocation of presence of bone tumors of the condylar process, dislocation of the articular disc and asymmetrical deformation of the jaws, not accompanied by a temporomandibular joint (TMJ) disorder, remains relevant. The purpose of the study is to determine the criteria for “nilateral condylar hyperplasia” diagnosis with the further formation of a combined treatment plan. The study included 77 patients of both sexes aged 15-25 years with clinically detectable facial asymmetry. All of them underwent multislice computed tomography or cone-beam computed tomography, as well as magnetic resonance imaging of the TMJ. Based on the results obtained several groups with established radiological diagnoses were identified: 1 – secondary osteoarthritis deformans – 14 people (18.18%), 2 – condylar hypoplasia – 15 people (19.48%), 3 – chondroma/osteoma of the condylar process – 11 people (14.29%), 4 – condylar hyperplasia – 14 people (18.18%), 5 – asymmetrical deformity of the jaws, not caused by TMJ pathology – 19 people (24.68%), 6 – dislocation of the articular disc – 4 people (5.19%). Patients from groups 2, 4 and 5 were administered a scintigraphy for differential diagnosis and clarification of the diagnosis. According to the results of scintigraphy, the final diagnosis of hyperplasia was established in 12 patients (15.58%). As a result of the study, it was revealed that the development of an objective method for diagnosing pathological and healthy growth zones of the TMJ is required, allowing to determine the optimal volume of intra-articular resection of the condylar process at the stage of preoperative planning which will ensure normalization of occlusion and facial symmetry without further need for orthognathic surgery. In addition, regardless of the X-ray examination findings, all patients with identified facial asymmetry require scintigraphy. The exception is patients with congenital condylar hypoplasia, since in them the percentage of accumulation of the radiopharmaceutical drug will a priori be different, and the results will be uninformative.