Mandibular Border Research Articles

The Use of Submental Artery Perforator Island Flap Without Including Digastric Muscle in the Reconstruction of Lower Face and Intraoral Defects.

For reconstruction of intraoral and lower face defects, it is important to use flaps that prevent reliable and pliable soft tissue and it is possible to use aesthetically most compatible with recipient site. In this study, the authors aimed to present their clinical experiences and results of lower face and intraoral defects reconstructions with submental artery island perforator flap without including the digastric muscle to have a thinner and useful flap. Six patients with lower face and intraoral defects that were reconstructed using the submental artery island flap between November 2013 and February 2015 were retrospectively analyzed. Patient demographics, age, sex, defect etiologies, and complications were assessed. Hand Doppler examination was performed and submental artery marked preoperatively. The superior border of the flap was designed at least 1 cm away from the mandibular border to avoid injury to the marginal mandibular nerve and prevent lip eversion. After the identification of the submental artery via the retrograde dissection, the anterior belly of the digastric muscle was not included the flap to prevent a thinner flap. After the dissection, the island flap was transferred to the defect site through a subcutaneous tunnel. The donor sites were closed primarily. A partially flap necrosis was occurred in 1 patient due to hematome in the tunnel around the pedicle. The wound healed uneventfully with conservative management. In the remaining patients there were no complications. The submental artery perforator island flap without including the digastric muscle is a reliable and suitable option for the medium-sized defects in the lower face and intraoral defects.

Kinematic analysis of mandibular motion before and after orthognathic surgery for skeletal Class III malocclusion: A pilot study

Objectives: The aim of the study was to detect the changes in 3D mandibular motion after orthognathic surgery for skeletal Class III malocclusion.Method: Using a 3D motion analyzer, free mandibular border movements were recorded in nine patients successfully treated for skeletal Class III malocclusion and in nine patients scheduled for orthognathic surgery. Data were compared using Mann–Whitney non-parametric U-test.Results: The results showed no differences between the groups in the total amount of mouth opening, protrusion, and in lateral excursions, but the percentage of mandibular movement explained by condylar translation was significantly increased after surgery (20% vs. 23.6%). During opening, the post-surgery patients showed a more symmetrical mandibular interincisal point and condylar path than pre-surgery patients (p < 0.01).Discussion: Patients treated with orthognathic surgery for skeletal Class III malocclusion recover a good and symmetric temporomandibular joint function.

Applied anatomy of the maxillofacial and mandibular regions of the dromedary camel (Camelus dromedarius)

The study involved some osteometric parameters of the upper jaw and mandible of 6 apparently healthy adult camels without any apparent skeletal disorders. A total of 21 head measurements and indices were recorded in the present study. The supraorbital foramina distance, infraorbital foramina distance, skull length, skull width, cranial length, nasal length and skull width of the Indian one-humped dromedary camel were 6.35±0.047 cm, 8.41±0.076 cm, 48.75±0.244 cm, 22.66±0.108 cm, 32.73±0.484 cm and 16.89±0.283 cm, respectively. The skull index was 46.51±0.29. In addition, the distances from facial tuberosity to the infra-orbital canal and from the latter to root of the 1st upper premolar tooth were 2.91±0.068 cm and 3.21±0.078 cm, respectively. The length and height of the mandible were 42.98±0.624 cm and 22.58±0.287 cm, respectively. Furthermore, the distances from the lateral alveolar root to mental foramen and from the mental foramen to caudal mandibular border were 9.22±0.059 cm and 32.12±0.165 cm, respectively. In the present study, the distances from mandibular foramen to the base of mandible as well as from caudal border of mandible to below the mandibular foramen were 8.84±0.085 cm and 6.32±0.048 cm, respectively. Also, the distances from the base of mandible to condyloid fossa and from the latter to the maximum height of mandible were 18.38±0.15 cm and 4.175±0.046 cm, respectively. Finally, the distance from caudal border of mandible to mandibular foramen and from the latter to mandibular angle were 5.88±0.055 cm and 8.29±0.079 cm, respectively.

Evaluation of three-dimensional mandibular movements after reconstruction with free fibula flap.

SUMMARYSeven patients who underwent mandibular reconstruction with a fibula free flap (one on the midline, six on either right or left side) and were rehabilitated with implant supported prostheses, performed free mandibular border movements (maximal mouth opening and closing, right and left lateral excursions, protrusion) that were recorded by a non-invasive motion analyser. Temporomandibular joint (TMJ) kinematic parameters were compared to those calculated in healthy control subjects using z-scores. Maximum mouth opening was reduced in all patients, with z-scores ranging from -2.742 to -0.106, and performed with a reduced sagittal plane mandibular rotation. Interincisal point forward movement during protrusion was reduced in all but one patient. Lateral mandibular movements (displacement of the interincisal point) and bilateral condylar movements during mouth opening were very variable and sometimes asymmetrical. Mandibular rotation was also variable, with z-scores ranging from -1.265 to 1.388. Together with mandibular range of motion, we investigated biomechanical characteristics of TMJ motion that can provide further information about the joint without submitting the patient to harmful procedures, and that can be followed-up during healing. The investigation indicates those areas that need to be given special attention in preoperative planning, patient information and rehabilitation.

Lower face asymmetry: can we distract the mandibular lower border?

Lower face asymmetry: can we distract the mandibular lower border?

Clinical Application of Three-Dimensional Printing Techniques in Contour Surgery of Mandilble

INTRODUCTION: Mandibular contour surgery has been a powerful tool to reduce the width of lower face and create an oval shape that’s more appealing to Asian women. Intra-operative approach, which spared the transcutaneous incision and avoided the possibility of scar formation, has been the mainstream method of operation. However, due to its limitation of operative field and inaccessibility of gonial angle, it’s hard to resect an accurate amount according to pre-operative planning. Thus, we transformed the pre-operative CT scan into three-dimensional templates, to see if it can help reduce the complication caused by over- or under-resection. OBJECTIVES: We present our experience of mandible contour surgery with the assistance of 3D-printing for pre-operative survey and intra-operative guidance. MATERIALS & METHODS: From March 2013 to May 2014, 69 patients received contour surgery of mandible under the assistance under the assistance of three-dimensional printing. Patients’ skull templates were obtained during pre-operative evaluation. After discussing with patients, resection margin was marked on the template and translated to operative field during operation. Drainage tubes were inserted at each side and removed on the next morning. RESULTS: Most of patients (92%) were satisfied with the result. No major complications, such as overt excision or nerve severance, were noted. Resected bone segments were compatible with pre-operative designs and few contour irregularities were complained. CONCLUSIONS: Three-dimensional printing skull templates from pre-operative CT scan are beneficial to mandibular contour surgery in three ways: 1. It can assist pre-operative counseling and help patients have better understanding of the exact anatomy of his/her mandible. 2. It helps surgeons with pre-operative plan and designing the ostectomy line. 3. It offers the complete detail of mandibular border, gonial angle with its relative position to mental foramen and oblique ridge. Besides, it can better simulate the intra-operative view that surgeons will encounter during the operation and provide a better guidance while minimizing the possibility of nerve injury or over-resection.

Treatment of Dentofacial Deformities Secondary to Osteochondroma of the Mandibular Condyle Using Virtual Surgical Planning and 3-Dimensional Printed Surgical Templates

One-stage treatment for condylar osteochondroma and secondary facial deformities by resection and reconstruction of the mandibular condyle, orthognathic surgery, and mandibular contouring has been reported recently. This study investigated the clinical feasibility of treating osteochondroma of the mandibular condyle and secondary dento-maxillofacial deformities by virtual surgical planning and 3-dimensional (3D) printed surgical templates. A composite skull model with accurate dentition was obtained with data from spiral computed tomography (CT) and surface scanning of the dental arch. Virtual surgical simulation was performed using Dolphin Imaging 11.7 Premium and Mimics software after a comprehensive 3D diagnosis and surgery planning. Surgical templates were fabricated by 3D printing using data from virtual surgical simulation for guidance of excision of the mandibular condyle with osteochondroma, reconstruction of the mandibular condyle, mandibular contouring, and reconstruction of a normal occlusion. Le Fort I osteotomy of the upper jaw and genioplasty were performed when indicated. The linear difference between virtually simulated and postoperative skull models was evaluated. All surgeries were successfully simulated using virtual surgical planning, and the guiding templates were successfully applied for all patients. Successful reconstruction of condylar function, normal occlusion, and symmetry of the facial profile was achieved. Postoperative CT scans and quantitative analysis showed that virtual surgical plans provided acceptable accuracy in the operating room. The linear difference of the incisors and first molars was no more than 1.4 mm, and the greatest difference was found for the menton landmark, which was up to 2.4 mm. Results from this study suggested that virtual surgical planning and guiding templates facilitated accurate diagnosis, treatment planning, accurate osteotomy, repositioning of bony segments, and contouring of the mandibular border in the treatment of condylar osteochondroma and secondary facial asymmetry.

Tumor maligno derivado de melanocitos en piel de un bovino de presentación inusual: estudio de caso

Los tumores melanocíticos o melanomas en los animales domésticos incluyen neoplasias compuestas por células productoras de melanina. En los bovinos, estos tumores son poco frecuentes y la mayoría son benignos; mientras que los malignos son de poca presentación. El artículo registra el caso de un bovino hembra mestizo de 38 meses de edad con una masa fluctuante, localizada entre el borde mandibular y la región parotídea izquierda, de aproximadamente tres meses de evolución, con crecimiento más evidente en los últimos treinta días. Después de su escisión quirúrgica, se remite una muestra conservada en formalina tamponada al 10 % al Laboratorio de Patología de la Universidad de Nariño, consistente en un fragmento de 7,0 × 10,5 × 8,0 cm, de forma elipsoide, con piel y pelo en una de sus caras, superficie irregular, color pardo negruzco, consistencia semiblanda al corte y presencia de contenido translúcido de aspecto viscoso para el procesamiento e inclusión en parafina y cortados a 5 μm de espesor y tincionados con coloración de hematoxilina-eosina. El tejido remitido se catalogó como una neoplasia de comportamiento maligno derivada de melanocitos, debido a sus características celulares: patrón de crecimiento, patrón de distribución, severo pleomorfismo celular, anisocitosis, megalocitosis, pleomorfismo nuclear, anisocariosis, megalocariosis y afectación de las paredes de los vasos sanguíneos; adicionalmente, al bloque de parafina se le realizó un corte para procesamiento inmunohistoquímico, empleando los marcadores monoclonales S-100 DAKO® y Melan A DAKO®, contrastado con hematoxilina de Meyer. Se evidencia fuerte inmunomarcación de las células neoplásicas, y se constituye en el primer caso registrado de esta patología en Nariño (Colombia).

Assessment of the OsteoMark-Navigation System for Oral and Maxillofacial Surgery

To assess the accuracy of a novel navigation system for maxillofacial surgery using human cadavers and a live minipig model. We tested an electromagnetic tracking system (OsteoMark-Navigation) that uses simple sensors to determine the position and orientation of a hand-held pencil-like marking device. The device can translate 3-dimensional computed tomographic data intraoperatively to allow the surgeon to localize and draw a proposed osteotomy or the resection margins of a tumor on bone. The accuracy of the OsteoMark-Navigation system in locating and marking osteotomies and screw positions in human cadaver heads was assessed. In group 1 (n = 3, 6 sides), OsteoMark-Navigation marked osteotomies and screw positions were compared to virtual treatment plans. In group 2 (n = 3, 6 sides), marked osteotomies and screw positions for distraction osteogenesis devices were compared with those performed using fabricated guide stents. Three metrics were used to document the precision and accuracy. In group 3 (n = 1), the system was tested in a standard operating room environment. For group 1, the mean error between the points was 0.7 mm (horizontal) and 1.7 mm (vertical). Compared with the posterior and inferior mandibular border, the mean error was 1.2 and 1.7 mm, respectively. For group 2, the mean discrepancy between the points marked using the OsteoMark-Navigation system and the surgical guides was 1.9 mm (range 0 to 4.1). The system maintained accuracy on a live minipig in a standard operating room environment. Based on this research OsteoMark-Navigation is a potentially powerful tool for clinical use in maxillofacial surgery. It has accuracy and precision comparable to that of existing clinical applications.

Assessment of position of mandibular canal in relation to mandibular plane in different growth patterns

ObjectivesTo evaluate the position and curvature of mandibular canal in relation to mandibular plane in horizontal (HG), average (AG) and vertical (VG) growth patterns. Methods100 lateral cephalograms were screened & analysed from amongst patient's records available in the institution. The growth pattern was assessed by FMA angle, Y-Axis, SN-Go-Gn angle and Jaraback's ratio, on the basis of these values, a sample was selected of 20 lateral cephalographs each in horizontal, average and vertical growth pattern. Rickett's Xi point was identified and mandibular canal was traced on each lateral cephalogram using Xi point which denotes the origin of mandibular canal. Distance between, Gonial point to Xi point, Mental foramen to mandibular plane (MF–M), Mandibular foramen to pterygoid vertical (Xi–PTV) and from deepest point on mandibular canal to mandibular plane (Mc–M) were measured to evaluate the position and curvature of mandibular canal in different growth patterns. ResultsIt was observed that, the distance from gonial point to mandibular foramen, mental foramen to mandibular border, mandibular foramen to pterygoid vertical was increased in horizontal growth pattern i.e., 22.05 mm ± 1.82, 15.12 mm ± 1.06, 57.20 mm ± 1.23, whereas it was reduced in vertical growth pattern i.e., 14.90 mm ± 1.55, 8.84 mm ± 1.41, 47.95 mm ± 2.25 respectively. Depth of curvature of mandibular canal was increased in horizontal growth pattern, 22.25 mm ± 4.89; while it was reduced in vertical growth pattern i.e., 16.32 mm ± 1.18. ConclusionsThe findings of this study showed that the position and curvature of the mandibular canal reflect the outer morphology and growth pattern of the mandible.

The relationship of the marginal mandibular nerve to the mandibular osseocutaneous ligament and lesser ligaments of the lower face.

An in-depth understanding of the nuances of facial anatomy is the best means of preventing complications during facelift surgery. An appreciation of the operative details is complicated not only by the complexity of the anatomy but also by the variability in the nomenclature used. The authors have attempted to clarify these issues by detailing the relationships of the ligaments of the lower face both to each other and to the marginal mandibular nerve. The mandibular ligament, the platysma mandibular ligament, and the marginal mandibular nerve were identified in 22 cadaver halves. The gonial angle, and the lower mandibular border were used as perpendicular reference lines. The mean length, height, and depth of the mandibular ligament and the platysma mandibular ligament were calculated. The mean distance of the mandibular ligament from the gonial angle along the mandibular border was also noted:it was always located superior to the platysma mandibular ligament. The marginal mandibular "danger zone" was identified a quarter of the length of the mandibular body along the lower jaw border. Finally variability in nomenclature of the lower face ligaments was clarified. A topographic map of the structures of surgical importance in the lower face was constructed in the hope that this will prevent surgical errors during facelift surgery.

Anatomic Relationship between Mental Foramen and Peripheral Structures Observed By Cone-Beam Computed Tomography

Backgroud: This study investigated the anatomic relationship between mental foramen and peripheral structures using cone-beam computed tomography. Methods: In total, 172 cone-beam computed tomography images were evaluated. Mental foramen number, size, and form were recorded, and their three-dimensional relationships with mandibular premolar root apices were investigated. The percentile position of each mental foramen relative to bony reference points was measured, and distances from mental foramen to the cement enamel junctions of the mandibular premolars were determined. Data were analyzed and compared among groups defined by age and sex using one-way analysis of variance and Student’s t-test, respectively (significance defined as P<0.05). Results: Most of the subjects had a single mental foramen on each side; only 5.81% had double foramina. The mean horizontal and vertical MF diameters were 5.14 (1.10) mm and 3.85 (0.72) mm, respectively. 67% of mental foramen had an oval horizontal form and the others were round. Mean distances from mental foramen to the alveolar crest and inferior mandibular border were 11.88 (2.49) mm and 13.65 (1.75) mm, respectively. The cementoenamel junctions of mandibular premolars were ~14 mm superior to mental foramen were most commonly positioned in line with the longitudinal axis of the mandibular second premolar. Conclusions: Most mental foramen were located in line with the longitudinal axis of the mandibular second premolar. The detailed information about the relationship between MF and peripheral structures obtained in this study will facilitate dental surgery in this oral and maxillofacial region.

English

Introduction: Orthodontic treatment in-deep bite subjects has generally been focused on the correction of excessive vertical coverage (overbite); however, the impact on functional problems following treatment has not been well evaluated. This study aimed to investigate the differences in mandibular movements between deep bite and normal occlusion, and to compare the functional changes of mandible in the subjects with deep bite before and after treatment. Methods: This study included students from School of Dentistry, China Medical University (CMU), and employees from CMU Hospital. The participants were categorized into normal bite (n = 11) and deep bite (n = 16) groups. Considering the clinical practicability, convenience and affordability, Digi Gnatho software (Japan), was used to analyze mandibular movements recorded by digital video camera. Results: No significant difference was observed in the left side masticatory movements between two groups. Significant difference was only detected in the horizontal direction of right side mastication. All of the velocities and masticatory cycle duration of both sides showed no difference. In the mandibular border movements, protrusive movements in deep-bite group were distinct from normal occlusion group. Normal occlusion group had a larger range of mandibular movements compared to deep bite group. Conclusions: Different degrees of vertical coverage of the incisors not only presented differences in the ranges of masticatory movements and border movements, but also had an impact on the final occlusal phase of mastication.

The modifications of the sagittal ramus split osteotomy: a literature review.

Background:In 1953, the sagittal ramus split osteotomy was introduced by Obwegeser. For many years, and in some countries still, this technique has defined the term oral and maxillofacial surgery.Methods:The basic design of the sagittal ramus split surgical procedure evolved very quickly. The original operation technique by Obwegeser was shortly after improved by Dal Pont’s modification. The second major improvement of the basic technique was added by Hunsuck in 1967. Since then, the technical and biological procedure has been well defined. Resolution of the problems many surgeons encountered has, however, taken longer. Some of these problems, such as the unfavorable split or the damage of the inferior alveolar nerve, have not been satisfactorily resolved.Results:Further modifications, with or without the application of new instruments, have been introduced by Epker and Wolford, whose modification was recently elaborated by Böckmann. The addition of a fourth osteotomy at the inferior mandibular border in an in vitro experiment led to a significant reduction of the torque forces required for the mandibular split.Conclusions:The literature was reviewed, and the last modifications of the successful traditional splitting procedure are presented narrowly. It indicates the better the split is preformatted by osteotomies, the less torque force is needed while splitting, giving more controle, a better predictability of the lingual fracture and maybe less neurosensory disturbances of the inferior alveolar nerve.

Attachment Rate of the Inferior Alveolar Nerve to Buccal Plate During Bilateral Sagittal Split Osteotomy Influences Self-Reported Sensory Impairment

This study was aimed to investigate a modified buccal osteotomy technique and whether the integrity of the lingual part of the lower border influences the attachment of the neurovascular bundle to the proximal segment of the mandible during a sagittal split osteotomy without increasing the number of bad splits. The presence of self-reported sensibility disturbance in the lower lip at the last follow-up visit was assessed. This study included 220 and 133 patients with bilateral sagittal split osteotomy undergoing the classical and the new modified buccal osteotomy techniques, respectively. In the new technique, the lower border is divided into a lingual fragment that remains incorporated in the tooth-bearing fragment and a buccal fragment that comes with the proximal fragment (buccal plate). In the classical technique, the inferior alveolar nerve was attached to the proximal segment of the mandible in more than one third of operation sites (36.36% on the right and 40.91% on the left) compared with less than one fourth of the operation sites using the new technique (9.73% on the right and 23.01% on the left). The overall figure of self-reported changed sensibility was 09.40% (12/128) in the new technique compared to 15.12% in the classical technique. We present a suitable improvement to the classical buccal osteotomy technique that allows less manipulation and injury of the inferior alveolar nerve with consequent reduction in self-reported postoperative changes in lower lip sensation

Mandibular rotation revisited: What makes it so important?

Orthodontists have long been aware that mandibular rotation takes place during growth, but most have underestimated its importance. This is so because the distinction between the true rotation and the rotation of the mandibular plane is typically not made. Traditionally, orthodontists have focused on the mandibular plane, which changes little because modeling on the lower mandibular border largely hides the true rotation that occurs. Furthermore, orthodontists must understand that changes in tooth position—over which they have great control—play an important role in determining the true rotational changes that occur. Such an appreciation is of particular importance when evaluating Class II cases, for which true rotation is critically important, in terms of both the development and solution of the problem. Clinically, they must be aware of and able to use the various centers of rotation to prevent deleterious changes from occurring and to orthopedically correct the problems that have developed. Orthodontists must understand that true rotation is the primary determinant of chin position and a major determinant of condylar growth direction, mandibular modeling, and dentoalveolar compensations. They must learn how to take advantage of the mandible's capacity to adapt to rotational changes.

In Vitro Comparison of the Sagittal Split Osteotomy With and Without Inferior Border Osteotomy

By adding an osteotomy of the inferior border of the mandibular body to the classic sagittal split osteotomy, the authors expected to prevent unfavorable splits and damage to the inferior alveolar nerve. Thirty-five human mandibles were used to perform 70 sagittal split osteotomies as an in vitro study. Conducted as a split-mouth model, each mandible was split at the midline. One side of the mandible was split using the traditional Obwegeser-Dal Pont technique, and the other side was split in the same manner with an additional osteotomy of the inferior mandible border. The torque used to split the mandible was measured, and the fracture line of the mandible was recorded. The average torque associated with the original technique was 1.38 Nm (standard deviation, 0.60 Nm), with a fracture line along the mandibular canal. The average torque required to split the hemimandible with the modified technique was 1.02 Nm (standard deviation, 0.50 Nm), a significant (P < .001) difference, with a fracture line parallel to the posterior ramus of the mandible. The fracture pattern depended significantly on the technique used (P < .001), but not on the applied torque force. By adding an osteotomy of the inferior mandibular border to the sagittal split osteotomy, less torque was needed to split the mandible. The fracture line was more predictable, even when all the surgical manipulations were performed at a safe distance from the inferior alveolar nerve.

Finite Element Analysis of the Effect of Mastication on Endochondral Ossification During the Consolidation Period of Mandibular Distraction Osteogenesis

Masticatory movements have been hypothesized to have a close relationship with the endochondral ossification of mandibular distraction gap tissue. This study investigated whether the local biomechanical environment of the gap tissue contributes to endochondral ossification of new tissue during the early consolidation period of mandibular distraction osteogenesis (DO) in the case of unstable fixation. A 3D finite element model was used to evaluate the compressive hydrostatic pressure stresses and shear stresses of new tissue in the unilateral mandibular DO gap after 4 weeks of consolidation. Four basic clenching conditions—namely clenching in the intercuspal position (ICP), left unilateral molar clenching (L-MOL), right unilateral molar clenching (R-MOL), and incisal clenching (INC)—were investigated. The gap tissue was always subjected to compressive hydrostatic pressure stresses and shear stresses, but the stress value of a specific location varied with clenching conditions. Under ICP, the gap tissue gained the maximum compressive hydrostatic pressure stresses and shear stresses; L-MOL experienced lower compressive hydrostatic pressure stresses and shear stresses, followed by R-MOL, while INC experienced minimum stress. During ICP, L-MOL, and R-MOL conditions, the junction area of lingual and distal surfaces of the gap tissue showed a greater compressive hydrostatic pressure stress, especially the area close to the inferior mandibular border, an area in which endochondral ossification has been observed in vivo during the early phase of consolidation. The results suggest that masticatory movement may contribute to endochondral ossification in the distraction gap in the early phase of consolidation under unstable fixation. During DO, stable fixation is an important factor in ensuring comparability of the results.

Mandibular cortical indices on cone‐beam computed tomography images in osteoporotic women on treatment with oral bisphosphonates

To evaluate the mandibular cortical indices in osteoporotic women receiving oral bisphosphonates (oBPs). The study group included 46 Caucasian women aged over 55 years on treatment with oBPs for postmenopausal osteoporosis. Information recorded included age, weight, height, type of oBP, duration of treatment, comorbid conditions and coadjuvant medication. Forty-six age-matched Caucasian women with no known diagnosis of osteoporosis were selected as the control group. All participants underwent cone-beam computed tomography, and the mandibular cortical width (MCW) and the height from the inferior mandibular border to the mental foramen (MBMF) were measured. The MBMF was similar in the participants with osteoporosis and in controls. MCW was significantly greater in the participants with osteoporosis than in the controls (p < 0.001). Mandibular cortical width should not be used to predict the risk of bisphosphonate-associated osteonecrosis of the jaws.

Treatment of Osteochondroma in the Mandibular Condyle and Secondary Dentofacial Deformities Using Surgery Combined With Orthodontics in Adults

Osteochondroma is a benign tumor that is rare in the craniofacial region. When it does occur, the condyle and coronoid process have been the most commonly affected sites. The secondary progressive malocclusion and facial asymmetry will be common physical signs in most cases. The traditional surgical treatment of osteochondroma of the mandibular condyle has been condylectomy, with or without reconstruction of the condyle. We believe more attention should be paid to restoring joint function, improving the facial appearance, correcting malocclusion, and re-establishing harmony among them. From January 2000 to March 2013, 27 patients (17 women and 10 men) who had been diagnosed with osteochondroma of a unilateral mandibular condyle underwent condylectomy and condylar reconstruction using a pedicled posterior mandibular border obtained by ramus osteotomy. The secondary dentofacial deformities were simultaneously corrected using orthognathic and facial contouring procedures, followed by orthodontic treatment, when necessary. Occlusion and temporomandibular joint pain and function, including the maximal mouth opening and maximal protrusion, were recorded preoperatively and postoperatively. The patients were followed for an average of 13 months (range 24 to 48). The outcomes of, and feedback information from the patients showed apparent improved joint function, with no cases of osteochondroma recurrence. The secondary dentofacial deformities were corrected significantly. Satisfactory occlusion was achieved with orthognathic and orthodontic treatment. Our data suggest that condylectomy and condylar reconstruction, with simultaneous correction of the secondary dentofacial deformities using orthognathic procedures, might be a better approach to manage osteochondroma accompanied by dentofacial deformities. In addition to facial contouring procedures, orthodontic treatment should be considered for better improvement in facial esthetics and occlusion.