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State of the Art in Craniofacial Surgery

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Plastic, Reconstructive and Aesthetic Surgery/Aesthetic Medicine".

Deadline for manuscript submissions: closed (20 December 2022) | Viewed by 29633

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Dr. Michael S. Hu

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Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
Interests: plastic and reconstructive surgery, particularly craniofacial surgery, microsurgery, and general reconstructive surgery.
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The craniofacial region comprises the most complex and intricate anatomical structures in the human body. As a result of developmental defects, traumatic injury, or neoplastic tissue formation, the functional and aesthetic intricacies of the face and cranium are often disrupted. While reconstructive and aesthetic surgical techniques have long been innovated in this field, there are crucial limitations to the surgical restoration of craniomaxillofacial form and function. Fortunately, the rise of regenerative medicine and surgery has expanded the possibilities for patients affected with hard and soft tissue deficits, allowing for the controlled engineering and regeneration of patient-specific defects. Innovative advances made in material science, including scaffold-based delivery systems for precision tissue engineering, now offer new avenues for stimulating bone and soft-tissue formation at the site of the surgical correction of deficient craniofacial anatomy. This Special Issue aims to highlight the current state of the art in craniofacial surgery, spanning all areas of innovation within the specialty. Therefore, researchers (clinicians and scientists) in the fields of plastic and reconstructive surgery, oral and maxillofacial surgery, otolaryngology—head and neck surgery, and neurosurgery are encouraged to submit original articles or reviews to this Special Issue of the Journal of Clinical Medicine. We look forward to receiving your submissions!

Dr. Michael S. Hu
Guest Editor

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Craniofacial
Maxillofacial
Cleft lip/palate
Orofacial cleft
Orthognathic
Osteogenesis
Reconstruction
Aesthetics
Craniosynostosis
Cranioplasty

Published Papers (12 papers)

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12 pages, 3869 KiB

Open AccessArticle

Early Treatment of Unilateral Condylar Hyperplasia in Adolescents: Preliminary Results

by Sergio Olate, Victor Ravelo, Juan Pablo Alister, Henrique Duque Netto, Ziyad S. Haidar and Roberto Sacco

J. Clin. Med. 2023, 12(10), 3408; https://doi.org/10.3390/jcm12103408 - 11 May 2023

Viewed by 2381

Abstract

Facial asymmetry associated with unilateral condylar hyperplasia (UCH) is a rare disease. The aim of this study was to evaluate the clinical conditions of progressive facial asymmetry in young subjects treated with high condylectomy. A retrospective study was performed including nine subjects diagnosed with UCH type 1B and progressive facial asymmetry around 12 years old with an upper canine progressing towards dental occlusion. After an analysis and a decision of treatment, orthodontics began one to two weeks prior to the condylectomy (with a mean vertical reduction of 4.83 ± 0.44 mm). Facial and dental asymmetry, dental occlusion, TMJ status and an open/closing mouth were analyzed before surgery and in the final stage of treatment, almost 3 years after surgery. Statistical analyses were performed using the Shapiro–Wilk test and a Student’s t-test considering a p value of <0.05. Comparing T1 (before surgery) and T2 (once orthodontic treatment was finalized), the operated condyle showed a similar height to that observed in stage 1 with a 0.12 mm difference in height (p = 0.8), whereas the non-operated condyle showed greater height increase with an average of 3.88 mm of vertical growth (p = 0.0001). This indicated that the non-operated condyle remained steady and that the operative condyle did not register significant growth. In terms of facial asymmetry in the preoperative stage, a chin deviation of 7.55 mm (±2.57 mm) was observed; in the final stage, there was a significant reduction in the chin deviation with an average of 1.55 mm (±1.26 mm) (p = 0.0001). Given the small number of patients in the sample, we can conclude that high condylectomy (approx. 5 mm), if performed early, especially in the mixed-dentition stage before full canine eruption, is beneficial for the early resolution of asymmetry and thus the avoidance of future orthognathic surgery. However, further follow-up until the end of facial growth is required. Full article

(This article belongs to the Special Issue State of the Art in Craniofacial Surgery)

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9 pages, 2079 KiB

Open AccessArticle

SEMAC + VAT for Suppression of Artifacts Induced by Dental-Implant-Supported Restorations in Magnetic Resonance Imaging

by Lauren Bohner, Marcel Hanisch, Hian Parize, Newton Sesma, Johannes Kleinheinz and Norbert Meier

J. Clin. Med. 2023, 12(3), 1117; https://doi.org/10.3390/jcm12031117 - 31 Jan 2023

Cited by 1 | Viewed by 1390

Abstract

The purpose of this study was to assess the feasibility of SEMAC + VAT to reduce artifacts induced by dental implant-supported restorations, such as its impact on the image quality. Dental-implant supported restorations were installed in a dry mandible. Magnetic resonance scans were acquired on a 3-Tesla MRI system. Artifact suppression (SEMAC + VAT) was applied with different intensity modes (weak, moderate, strong). Artifacts assessment was performed by measuring the mandible volume increase in MRI images prior (reference dataset) and after installation of dental implant-supported prosthesis. Image quality was assessed by two examiners using a five-point scale. Inter-examiner concordance and correlation analysis was performed with Cronbach’s alpha and Spearman’s test with a significance level at p = 0.05. Mandible volume increased by 60.23% when no artifact suppression method was used. By applying SEMAC + VAT, the volume increase ranged from 17.13% (strong mode) to 32.77% (weak mode). Visualization of mandibular bone was positively correlated with SEMAC intensity degree. SEMAC + VAT reduced MRI artifacts caused by dental-implant supported restorations. A stronger suppression mode improved visualization of mandibular bone in detriment of the scanning time. Full article

(This article belongs to the Special Issue State of the Art in Craniofacial Surgery)

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14 pages, 541 KiB

Open AccessArticle

Elective Tracheotomy in Patients Receiving Mandibular Reconstructions: Reduced Postoperative Ventilation Time and Lower Incidence of Hospital-Acquired Pneumonia

by Johannes G. Schuderer, Leonie Reider, Michael Wunschel, Gerrit Spanier, Steffen Spoerl, Maximilian Josef Gottsauner, Michael Maurer, Johannes K. Meier, Peter Kummer, Torsten E. Reichert and Tobias Ettl

J. Clin. Med. 2023, 12(3), 883; https://doi.org/10.3390/jcm12030883 - 22 Jan 2023

Cited by 1 | Viewed by 1155

Abstract

Elective tracheotomy (ET) secures the airway and prevents adverse airway-related events as unplanned secondary tracheotomy (UT), prolonged ventilation (PPV) or nosocomial infection. The primary objective of this study was to identify factors predisposing for airway complications after reconstructive lower ja surgery. We reviewed records of patients undergoing mandibulectomy and microvascular bone reconstruction (N = 123). Epidemiological factors, modus of tracheotomy regarding ET and UT, postoperative ventilation time and occurrence of hospital-acquired pneumonia HAP were recorded. Predictors for PPV and HAP, ET and UT were identified. A total of 82 (66.7%) patients underwent tracheotomy of which 12 (14.6%) were performed as UT. A total of 52 (42.3%) patients presented PPV, while 19 (15.4%) developed HAP. Increased operation time (OR 1.004, p = 0.005) and a difficult airway (OR 2.869, p = 0.02) were predictors, while ET reduced incidence of PPV (OR 0.054, p = 0.006). A difficult airway (OR 4.711, p = 0.03) and postoperative delirium (OR 6.761, p = 0.01) increased UT performance. HAP increased with anesthesia induction time (OR 1.268, p = 0.001) and length in ICU (OR 1.039, p = 0.009) while decreasing in ET group (HR 0.32, p = 0.02). OR for ET increased with mounting CCI (OR 1.462, p = 0.002) and preoperative radiotherapy (OR 2.8, p = 0.018). ET should be strongly considered in patients with increased CCI, preoperative radiotherapy and prolonged operation time. ET shortened postoperative ventilation time and reduced HAP. Full article

(This article belongs to the Special Issue State of the Art in Craniofacial Surgery)

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8 pages, 914 KiB

Open AccessArticle

Symmetry of the Vermillion Height after Modified Rotation-Advancement Cheiloplasty

by Ivy Valdez Tangco, Kishor Bhandari, Chuan-Fong Yao, Ting-Chen Lu and Philip Kuo-Ting Chen

J. Clin. Med. 2022, 11(22), 6744; https://doi.org/10.3390/jcm11226744 - 15 Nov 2022

Cited by 1 | Viewed by 1518

Abstract

(1) Background: This study aimed to determine the postoperative vermillion symmetry between the cleft and non-cleft sides of patients with unilateral cleft lip during the early and late postoperative periods. (2) Methods: 57 patients with complete and 38 with incomplete unilateral cleft lips operated on between 2010 and 2014 were retrospectively evaluated within 1 month (T1), 9 months to 1 ½ years (T2), and more than 4 years (T3). Vermilion heights of the cleft and non-cleft sides were measured from frontal photographs. The Cleft Lip Component Symmetry Index (CLCSI) was used to determine the symmetry of the cleft and non-cleft sides and was then analyzed. (3) Results: Among the 95 patients studied, vermilion height was excessive on the cleft side throughout the three time periods. There was a significant increase in CLCSI from T1 to T2 for both complete and incomplete types, and a significant increase from T1 to T3 only in the incomplete group and no difference from T2 to T3 for both the groups. (4) Conclusions: Even with efforts to obtain a symmetric vermilion height during the primary cheiloplasty, vermilion height excess was noted with time in complete and incomplete cleft types. Secondary revisional vermilion surgery may be performed to achieve symmetry. Full article

(This article belongs to the Special Issue State of the Art in Craniofacial Surgery)

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9 pages, 1010 KiB

Open AccessArticle

Postoperative Delirium after Reconstructive Surgery in the Head and Neck Region

by Juergen Taxis, Steffen Spoerl, Andreas Broszio, Jonas Eichberger, Elisabeth Grau, Johannes Schuderer, Nils Ludwig, Maximilian Gottsauner, Gerrit Spanier, Annika Bundscherer, Torsten E. Reichert and Tobias Ettl

J. Clin. Med. 2022, 11(22), 6630; https://doi.org/10.3390/jcm11226630 - 9 Nov 2022

Cited by 4 | Viewed by 1407

Abstract

Postoperative delirium (POD) is an acute and serious complication following extended surgery. The aim of this study was to identify possible risk factors and scores associated with POD in patients undergoing reconstructive head and neck surgery. A collective of 225 patients was retrospectively evaluated after receiving reconstructive surgery in the head and neck region, between 2013 to 2018. The incidence of POD was examined with regards to distinct patient-specific clinical as well as perioperative parameters. Uni- and multivariate statistics were performed for data analysis. POD occurred in 49 patients (21.8%) and was strongly associated with an increased age-adjusted Charlson Comorbidity Index (ACCI) and a prolonged stay in the ICU (p = 0.009 and p = 0.000, respectively). Analogous, binary logistic regression analysis revealed time in the ICU (p < 0.001), an increased ACCI (p = 0.022) and a Nutritional Risk Screening (NRS) score ≠ 0 (p = 0.005) as significant predictors for a diagnosis of POD. In contrast, the extent of reconstructive surgery in terms of parameters such as type of transplant or duration of surgery did not correlate with the occurrence of POD. The extension of reconstructive interventions in the head and neck region is not decisive for the development of postoperative delirium, whereas patient-specific parameters such as age and comorbidities, as well as nutritional parameters, represent predictors of POD occurrence. Full article

(This article belongs to the Special Issue State of the Art in Craniofacial Surgery)

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10 pages, 3038 KiB

Open AccessArticle

TMJ Position in Symmetric Dentofacial Deformity

by Victor Ravelo, Gabriela Olate, Marcio de Moraes, Henry Garcia Guevara, Marcelo Parra and Sergio Olate

J. Clin. Med. 2022, 11(13), 3631; https://doi.org/10.3390/jcm11133631 - 23 Jun 2022

Cited by 5 | Viewed by 1934

Abstract

The aim of this research was to analyze the facial class, presence of malocclusion, and the mandibular plane and to relate this to the mandibular condyle position. A cross-sectional study in subjects under analysis for orthognathic surgery was done. The mandibular plane, the gonial angle, and the molar class were included to compare the coronal and sagittal position of the condyle and the joint space observed in the CBCT. The measurements were obtained by the same observer at an interval of two weeks. In addition, the Spearman test was performed to determine the correlation using a p value < 0.05 to observe any significant differences. Eighty-nine male and female subjects (18 to 58 years old, 24.6 ± 10.5) were included. In the coronal section, subjects with CIII had a greater mediolateral distance (MLD, p = 0.0001) and greater vertical distance (SID, p = 0.0001) than subjects with CII. In terms of the skeletal class and the mandibular plane, it was observed that subjects in the CII group had a greater mandibular angle (open angle) (p = 0.04) than the CII group and was related to the anterior position of the condyle. The most anterior condylar position was observed in the CII group (p = 0.03), whereas a posterior condylar position was significant in CIII subjects (p = 0.03). We can conclude that the sagittal position of the TMJ was related to the mandibular plane and the skeletal class showing a higher mandibular angle and most anterior position of the condyle in CII subjects and a lower mandibular angle and most posterior position of the condyle in CIII subjects. The implications for surgical treatment have to be considered. Full article

(This article belongs to the Special Issue State of the Art in Craniofacial Surgery)

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10 pages, 1739 KiB

Open AccessArticle

No Significant Bone Resorption after Open Treatment of Mandibular Condylar Head Fractures in the Medium-Term

by Michael-Tobias Neuhaus, Nils-Claudius Gellrich, Anna Katharina Sander, Bernd Lethaus, Dirk Halama and Rüdiger M. Zimmerer

J. Clin. Med. 2022, 11(10), 2868; https://doi.org/10.3390/jcm11102868 - 19 May 2022

Cited by 3 | Viewed by 1476

Abstract

Open treatment of condylar head fractures (CHF) is considered controversial. In this retrospective cohort study our primary objective was therefore to assess bone resorption and remodeling as well as patients function after open treatment of CHF in a medium-term follow-up (15.1 ± 2.2 months). We included 18 patients with 25 CHF who underwent open reduction and internal fixation, between 2016 and 2021, in our analysis. The clinical data and cone-beam computed tomography (CBCT) datasets were analyzed. The condylar processes were segmented in the postoperative (T1) and follow-up (T2) CBCT scans. Volumetric and linear bone changes were the primary outcome variables, measured by using a sophisticated 3D-algorithm. The mean condylar head volume decreased non-significantly from 3022.01 ± 825.77 mm³ (T1) to 2878.8 ± 735.60 mm³ (T2; p = 0.52). Morphological alterations indicated remodeling and resorption. The pre-operative maximal interincisal opening (MIO) was 19.75 ± 3.07 mm and significantly improved to 40.47 ± 1.7 mm during follow-up (p = 0.0005). Low rates of postoperative complications were observed. Open reduction of CHF leads to good clinical outcomes and low rates of medium-term complications. This study underlines the feasibility and importance of open treatment of CHF and may help to spread its acceptance as the preferred treatment option. Full article

(This article belongs to the Special Issue State of the Art in Craniofacial Surgery)

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10 pages, 1313 KiB

Open AccessArticle

Off-Label Treatment for Severe Craniomaxillofacial Fractures in Low-Income Countries—A Novel Operation Method with the External Face Fixator

by Christian Deininger, Valeska Hofmann, Marco Necchi, Susanne Deininger and Florian Wichlas

J. Clin. Med. 2022, 11(6), 1488; https://doi.org/10.3390/jcm11061488 - 9 Mar 2022

Cited by 5 | Viewed by 3810

Abstract

Introduction: Craniomaxillofacial fractures (CMF) are common in low-income countries (LIC). Due to limited resources, treatment of these fractures usually consists of interdental wiring or immobilization with a Barton bandage to maintain the reduction by permanent occlusion. These non-surgical treatment methods often lead to unsatisfactory results, such as a disturbed dental occlusion and lockjaw. The aim of this study is to present an off-label treatment option for CMF by applying a hand fixator as external face fixator (EFF) and to demonstrate the surgical method in detail. Materials and Methods: The feasibility and postoperative outcomes of this new off-label operation technique were evaluated by analyzing patients with CMF (n = 13) treated at an NGO hospital in Sierra Leone between 2015 and 2019. Results: The application of the EFF was feasible. The biggest advantage compared to the conventional non-operative methods was, that a dynamic occlusion was still possible during the 6 weeks healing period. Hence, patients could eat and drink almost normally and perform dental hygiene with the EFF in place. We did not discover pintrack infections or other complications. Three patients developed an oronasal fistula due to traumatic a palatal bone loss of about 7–8 mm which was treated by a palatal mucoperiosteal flap 15–20 days after the first operation. Discussion and Conclusions: In LIC, where plate osteosynthesis for CMF cannot be performed due to limited resources the application of an EFF is a promising alternative for a better outcome and an improved quality of life for the patients. Full article

(This article belongs to the Special Issue State of the Art in Craniofacial Surgery)

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13 pages, 3950 KiB

Open AccessArticle

A Retrospective Study on Single-Stage Reconstruction of the Ear following Skin Cancer Excision in Elderly Patients

by Alberto Bolletta, Luigi Losco, Mirco Pozzi, Michela Schettino and Emanuele Cigna

J. Clin. Med. 2022, 11(3), 838; https://doi.org/10.3390/jcm11030838 - 5 Feb 2022

Cited by 6 | Viewed by 5138

Abstract

Ear reconstructive surgery aims to solve the deformities caused by cancer excision. Despite the numerous surgical procedures described, recreating the complex anatomy of the ear still represents a challenge, particularly for young surgeons. The purpose of this exploratory pilot study is to review our experience with single stage reconstruction of the partial defects of the auricle, and propose an algorithm based on defect size, location, and characteristics. We retrospectively reviewed patients who underwent ear reconstruction after cancer excision at our institution between February 2018 and November 2020. The data collected included patients’ demographics, defect characteristics, reconstructive technique used, complications, and outcomes. The patients were evaluated at a minimum follow-up time of 12 months. Forty-six patients were included in the study. The most common cause for ear reconstruction was basal cell carcinoma. The mean area of defect was 4.3 cm² and the helix was the most frequent location of defect. Two patients experienced post-operative complications. At the one-year follow-up, difference in skin pigmentation was reported in 10 cases, a depressed contour of the ear was found in 4 cases, and moderate ear asymmetry was found in 11 cases. No patient needed a secondary procedure. In conclusion, the proposed reconstructive algorithm represents a reconstructive indication that is simple and characterized by low complication rates and good outcomes for both the patient and the surgeon. Full article

(This article belongs to the Special Issue State of the Art in Craniofacial Surgery)

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Review

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26 pages, 3964 KiB

Open AccessReview

Intrusion of Maxillary Posterior Teeth by Skeletal Anchorage: A Systematic Review and Case Report with Thin Alveolar Biotype

by Avram Manea, Cristian Dinu, Mihaela Băciuţ, Smaranda Buduru and Oana Almășan

J. Clin. Med. 2022, 11(13), 3787; https://doi.org/10.3390/jcm11133787 - 30 Jun 2022

Cited by 2 | Viewed by 4245

Abstract

This study aimed to review the literature related to the intrusion of maxillary posterior teeth in subjects needing pre-prosthetic restoration or orthodontic treatment due to anterior open bite, and to report a thin alveolar biotype case needing a pre-prosthetic intrusion of maxillary teeth by introducing a novel, personalized method of intrusion measurement. An electronic search was conducted between February 2022 and March 2022 in the following databases: PubMed, Scopus, Embase, Web of Science, and Lilacs; the terms “tooth movement techniques”, “orthodontic anchorage procedures”, “tooth intrusion”, “intrusion”, “molar”, “premolar”, and “human” were surveyed. Eighteen articles were included in this review; the mean amount of intrusion ranged from between 2.1 ± 0.9 mm and 4.57 ± 0.98 mm (being mostly 2–3 mm). The intrusion force varied between 100 and 500 g; 10 articles reported miniscrews (MS), 7 reported zygomatic plates (ZP), and 1 publication reported both anchorage types. The average treatment time was 6.9 months for MS and 7.9 months for ZP. Levelling the occlusal plane by intrusion of the upper posterior teeth can be achieved by skeletal anchorage. The stability of the obtained results, shortening treatment time, and controlling treatment outcome are the main goals for a complex surgical and orthodontic treatment approach. Full article

(This article belongs to the Special Issue State of the Art in Craniofacial Surgery)

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Other

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12 pages, 1022 KiB

Open AccessSystematic Review

State of the Art in Temporomandibular Joint Arthrocentesis—A Systematic Review

by Marta Siewert-Gutowska, Rafał Pokrowiecki, Artur Kamiński, Paweł Zawadzki and Zygmunt Stopa

J. Clin. Med. 2023, 12(13), 4439; https://doi.org/10.3390/jcm12134439 - 30 Jun 2023

Cited by 3 | Viewed by 1564

Abstract

Temporomandibular joint disorders are a heterogenic group of clinical conditions, which impair physiological functioning of the masticatory system. Arthrocentesis of the temporomandibular joint has become a widely approved method for non-invasive treatment, bridging the gap between conservative and surgical approaches. Regardless of technique, treatment is based upon joint lavage and lysis of the inflammatory fibrous tissue adhesions, which, in turn, improves joint mobility and reduces pain and closed lock. Recently, approaches for intra-articular injections have been proposed as adjuvant or replacement therapy. The aim of this study was to assess the most efficient technique of arthrocentesis. A systematic search based on PRISMA guidelines, including a computer search with specific keywords, a reference list search and a manual search, was performed. Relevant articles were selected after three search rounds for final review. The studies pulled for the analysis presented information about the relevant predictors, including the technique of arthrocentesis (single- or two-needle method), fluid used for lavage (Ringer lactate or saline), volume of the fluid, application of the injectable, number of interventions, pain (VAS) and mouth opening scores (MMO) and follow-up. All cohorts showed improvement in mouth opening, but significant pain reduction was observed only in cohorts treated either by arthrocentesis alone or arthrocentesis followed by intra-articular injectables. Intra-articular injectables used alone failed to reduce pain post-operatively when compared to other cohorts. We concluded that both double-needle and single-puncture arthrocentesis techniques are equally efficient. Application of the adjuvant injectable did not improve the outcomes of arthrocentesis performed alone. The volume of the fluid used for joint lavage and its chemical composition were not significant in clinical outcomes. However, due to the lack of homogeneity in the study settings, a meta-analysis could not be applied and a systematic review was conducted. We still, however, state that there is a knowledge gap in the current literature regarding the use of injectables alone, as well as a longitudinal follow-up, which provides information about treatment efficiency. More high-quality and randomized controlled trials are required to shed light on this subject. Full article

(This article belongs to the Special Issue State of the Art in Craniofacial Surgery)

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8 pages, 2152 KiB

Open AccessBrief Report

Central Giant Cell Granuloma in the Mandibular Condyle in a Teenager. A Case Report with Literature Review

by André Luís Costa Cantanhede, Sergio Olate, Adriano Freitas de Assis and Márcio de Moraes

J. Clin. Med. 2022, 11(14), 4239; https://doi.org/10.3390/jcm11144239 - 21 Jul 2022

Cited by 2 | Viewed by 2500

Abstract

Central giant cell granulomas (CGCG) are not common in the mandibular condyle. In teenagers, the problem is more complex because of difficulties in diagnosis and treatment involving the potential growth of the mandibular process and development of the face. In this short communication a case is presented of an eleven-year-old female under diagnosis of central giant cell granuloma affecting the mandibular condyle treated surgically in two steps using a condylectomy and vertical ramus osteotomy at the first time and later orthognathic surgery, showing the clinical evolution after 13 years of follow-up. In addition, we performed a review of the scientific reports related to CGCG in the mandibular condyle to compare this treatment with others, in terms of follow-up and results. We concluded that the CGCG affecting the mandibular head can be properly treated with low condilectomy, vertical mandibular ramus sliding osteotomy, and discopexy. Full article

(This article belongs to the Special Issue State of the Art in Craniofacial Surgery)

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