Results of orthodontic treatment of a child with asymmetrical micrognathia and the congenital mandibular condylar hyperplasia

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Aim. To analyze the results of orthodontic treatment of a child with asymmetrical micrognathia and mandiblar condylar hyperplasia.

Methods. The configuration of a face in the photos was evaluated and diagnostic models of the jaws were analyzed by using the Pont’s and Korkhaus methods in treatment dynamics. The physiological status of bone tissue, temporomandibular joints and teeth was studied by using orthopantomography and computed tomography. Functional disorders were detected by using special tests, including Eschler–Bittner's test and Ilyina-Markosyan’s test. Orthodontic treatment and stimulation of mandibular growth in the mixed dentition stage were undertaken with the single jaw removable appliances and the appliance improved by us for correction of the distal occlusion. The Damon Q bra­cket system with archwires was used in permanent dentition period.

Results. The child's convex facial profile was typical for distal occlusion and micrognathia. The facial asymmetry, increasing with mouth opening, and a decrease in mandibular range of motion indicated lesion of the right temporomandibular joint. The right condyle was enlarged on the orthopantomogram. The computed tomography showed that it was asymmetrically enlarged and had a cellular structure. There was detected asymmetric micrognathia. The comprehensive rehabilitation plan included orthodontic treatment, myotherapy, speech therapy, mechanotherapy. The use of removable orthodontic appliances led to the normal size of the dentition and their relation, significantly reduced functional disorders and improved facial aesthetics. Five years after completion of orthodontic treatment, the physiological occlusion and amplitude of the mandibular movements remained, but the right mandibular angle was flattened.

Conclusion. The comprehensive rehabilitation of a child with asymmetrical micrognathia and mandibular condylar hyperplasia started in mixed dentition stage provided conditions for the formation of normal permanent dentition and the improvement of functional disorders and facial aesthetics; our results allow us to suggest the positive effect of our tactics for treatment of the patient.

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About the authors

F S Ayupova

Kuban State Medical University

Author for correspondence.
Russian Federation, Krasnodar, Russia

R A Khotko

Kuban State Medical University

Russian Federation, Krasnodar, Russia

E L Vinichenko

Kuban State Medical University

Russian Federation, Krasnodar, Russia

V N Lovlin

Kuban State Medical University

Russian Federation, Krasnodar, Russia


  1. Ayupova F.S., Voskanyan A.R. Prevalence and structure of dentoalveolar anomalies in children (literature review). Ortodontiya. 2016; (3): 2–6. (In Russ.)
  2. Ayupova F.S., Tereshchenko L.F. Structure of dental alveolar anomalies in children taking orthodontic advice. Kursk Scientific and Practical Bulletin “Man and His Health”. 2013; (4): 50–54. (In Russ.)
  3. Drobakha K.V., Drobysheva N.S., Klimova T.V. et. al. Features of the functional state of the maxillofacial area in patients with transversal abnormalities caused by hyperplasia of condyloid process. Ortodontiya. 2018; (1): 16–23. (In Russ.)
  4. Maruo I.T. Class II Division 2 subdivision left malocclusion associated with anterior deep overbite in an adult patient with temporomandibular disorder. Dental Press J. Orthod. 2017; 22 (4): 102–112. doi: 10.1590/2177-6709.22.4.102-112.bbo.
  5. Kleinrok M. Funktsio­nal'nye narusheniya dvigatel'noy chasti zhevatel'nogo apparata. (Functional disorders of the masticatory system.) Monography. Lvov: GalDent. 2015; 256 p. (In Russ.)
  6. Soloviev M.M., Fadeev R.A., Andreishchev A.R. Refinements to the classification of malocclusions. Parodontologiya. 2012; (1): 64–70. (In Russ.)
  7. Trezubov V.N., Bulycheva E.A., Bystrova V.V. et. al. The role of the biolo­gical adaptive feedback in the complex pathogenetic treatment of diseases of the TMJ and masticatory muscles. Institut stomatologii. 2003; (3): 33–35. (In Russ.)
  8. Fadeev R.A., Kudryavtseva O.A. Features of diagnostics and rehabilitation of patients with dental anomalies complicated by diseases of the temporomandibular joints and masticatory muscles (part I). Institut stomatologii. 2008; (2): 44–45. (In Russ.)
  9. Fadeev R.A., Kudryavtseva O.A. Features of diagnostics and rehabilitation of patients with dental anomalies complicated by diseases of the temporomandibular joints and masticatory muscles (part II). Institut stomatologii. 2008; (4): 20–21. (In Russ.)
  10. Danilova M.A., Ishmurzin P.V., Zakharov S.V. The theoretical substantiation of myofunctional correction of sagittal occlusion abnormalities and temporomandibular joint dysfunction. Stomatologiya. 2012; (3): 65–69. (In Russ.)
  11. Khudoroshkov Yu.G., Ishmur­zin P.V., Danilova M.A. The impact of internal TMJ di­sorders on quality of life of patients with malocclusion. Stomatolo­giya. 2015; 94 (5): 55–57. (In Russ.) doi: 10.17116/stomat201594555-57.
  12. Conti P.C., Corrêa A.S., Lauris J.R. et. al. Management of painful temporomandibular joint clicking with different intraoral devices and counseling: a controlled study. J. Appl. Oral Sci. 2015; 23 (5): 529–535. doi: 10.1590/1678-775720140438.
  13. Caldas W., Conti A.C., Janson G. et. al. Occlusal changes secondary to temporomandibular joint conditions: a critical review and implications for clinical practice. J. Appl. Oral Sci. 2016; 24 (4): 411–419. doi: 10.1590/1678-775720150295.
  14. Santamaría-Villegas A., Manrique-Hernandez R., Alvarez-Varela E. et. al. Effect of removable functional appliances on mandibular length in patients with class II with retrognathism: systematic review and meta-analysis. BMC Oral Health. 2017; 17: 52. doi: 10.1186/s12903-017-0339-8.
  15. Megrabyan O.A., Danilova M.A., Ishmur­zin P.V. et. al. Pathogenic treatment characteristics of distal occlusion with mandibular retrognathia. Dental forum. 2018; (4): 47. (In Russ.)
  16. Ayupova F.S., Khotko R.A. Modern trends in the choice of tactic and method for the treatment of growing patients with distal occlusion (literature review). Pediatric dentistry and dental prophylaxis. 2020; 20 (2): 156–159. (In Russ.) doi: 10.33925/1683-3031-2020-20-2-156-159.
  17. Korbmacher H.M., Schwan M., Berndsen S. et al. Evaluation of a new concept of myofunctional therapy in children. Int. J. Orofacial Myology. 2004; 30: 39–52. PMID: 15832861.
  18. Mitsui S.N., Yasue A., Kuroda S. et. al. Long‐term stability of conservative orthodontic treatment in a patient with temporomandibular joint disorder. J. Orthodont. Sci. 2016; 5: 104–108. doi: 10.4103/2278-0203.186168.
  19. Topolnitskiy O.Z., Kalinina S.A., Shorstov Y.V. Improvement of methods of treatment of deformation of the lower jaws after occurred ankylosis of the lumino-­lower-male joint in a child age. SCIENCE4HEALTH 2018. Materials of the IХ International Scientific Conference. Moscow. 2018: 134.
  20. Torii K., Chiwata I. Occlusal adjustment using the bite plate-induced occlusal position as a reference position for temporomandibular disorders: a pilot study. Head Face Med. 2010; 6: 5. doi: 10.1186/1746-160X-6-5.
  21. Persin L.S., Nabiev N.V., Pankratova N.V. et. al. Kinesiography in dentistry. Evaluation of mandible's movements in 7–15 years aged children and teenagers. Dental Yug. 2010; (6): 10–14. (In Russ.)
  22. Persin L.S. Ortodontiya. Natsional'noe rukovod­stvo. V 2 t. T. 1. Diagnostika zubochelyustnykh anomaliy. (Orthodontics. National guide. In 2 vol. Vol. 1. The diagnostics of the dentoalveolar abnormalities.) Ed. by L.S. Persin. M.: GEOTAR-Media. 2020; 304 p. (In Russ.) doi: 10.33029/9704-5408-4-1-ONRD-2020-1-3304.
  23. Persin L.S. Ortodontiya. Natsional'noe rukovodstvo. V 2 t. T. 2. Lechenie zubochelyustnykh anomaliy. (­Orthodontics. National guide. In 2 vol. Vol. 2. The treatment of the dentoalveolar abnormalities.) Ed. by L.S. Persin. M.: ­GEOTAR-Media. 2020; 376 p. (In Russ.) doi: 10.33029/9704-5409-1-2-ONRD-2020-1-376.
  24. Ayupova F.S. Device for treating the cases of distal occlusion. Patent for invention RF No. 2256426С1. Bulletin No. 20, issued at 20.07.2005. (In Russ.)

Supplementary files

Supplementary Files
1. Рис. 1. Диагностические модели челюстей пациента А. до лечения: а — вид сбоку (справа); б — вид спереди; в — вид сбоку (слева)

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2. Рис. 2. Ортопантомограммы пациента А.: а — до начала ортодонтического лечения (9 лет); б — после завершения ортодонтического лечения (14 лет); в — изменённая суставная головка справа

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3. Рис. 3. Компьютерная томограмма пациента А. 9 лет: область тела нижней челюс­ти (а), суставные головки (б, в) нижней челюсти

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4. Рис. 4. Ортодонтическое устройство для устранения дистальной окклюзии: а — патент [24]; б — пластина для верхней челюсти; в — пластина для нижней челюсти; г — межчелюстная тяга

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5. Рис. 5. Диагностические модели челюстей пациента А. 11 лет после лечения съёмными ортодонтическими устройствами: а — вид справа; б — вид спереди; в — вид слева; г — верхняя челюсть; д — нижняя челюсть

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6. Рис. 6. Пациент А. 13 лет, фиксированы брекеты Damon Q

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© 2021 Ayupova F.S., Khotko R.A., Vinichenko E.L., Lovlin V.N.

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