An intraoral approach to treatment of condylar hyperplasia or high condylar process fractures using the intraoral vertico-sagittal ramus osteotomy.

PURPOSE: The intraoral vertico-sagittal ramus osteotomy (J Craniomaxillofac Surg 20:153, 1992) can be used to reduce high condylar process fractures and recontour hyperplastic condyles while simultaneously correcting the malocclusion. This article presents the technique and reports the clinical results. PATIENTS AND METHODS: A technique for removal and replantation of the condyloid process using the vertico-sagittal ramus osteotomy and rigid fixation was used to treat 23 patients with markedly displaced, high condylar process fractures and condylar hyperplasia associated with malocclusion. RESULTS: The replanted condyles did not show ischemic necrosis or any functional disturbance when followed for more than 3 years. All patients showed nearly normal mouth opening, with slight mandibular deviation, usually in sixth postoperative month. CONCLUSIONS: In selected patients, this technique allows intraoral accessibility to the condyle and its repositioning. The method is particularly useful to treat vertical discrepancies associated with the hyperplastic or hypoplastic condyle.