Application of a unilateral mandibular verticalization activator in the orthodontic treatment of a patient with unilateral post-traumatic mandibular ramus hypoplasia: a clinical case report

Relevance. Fractures of the mandibular condylar process represent a clinically significant type of mandibular injury and are commonly associated with trauma to the temporomandibular joint (TMJ). Conventional management usually involves mandibular immobilization using splints, followed by orthodontic treatment with different orthodontic appliances. Even when treatment outcomes are favorable, patients aged over 13 years frequently develop condylar hypoplasia and mandibular ramus hypoplasia on the affected side. These changes lead to mandibular asymmetry and the development of dentofacial anomalies, often requiring combined treatment involving orthodontic therapy and orthognathic surgery. Consequently, dental rehabilitation of patients with post-traumatic condylar hypoplasia remains a clinically relevant issue warranting further study.

Description of a clinical case. A clinical case of orthodontic treatment of a 17-year-old patient with unilateral post-traumatic hypoplasia of the condylar process with the orthodontic device “activator for verticalization of the lower jaw” developed by us is presented. A clinical case of orthodontic treatment in a 17-year-old patient with unilateral post-traumatic hypoplasia of the mandibular condylar process is presented. Treatment was carried out using a custom-designed orthodontic appliance – a unilateral mandibular verticalization activator developed by the authors.

Conclusion. Application of the unilateral mandibular verticalization activator in a 17-year-old patient with unilateral post-traumatic condylar hypoplasia resulted in stimulation of condylar growth and remodeling, with improvement in mandibular form and articulation. The findings suggest that the use of a custom-designed orthodontic activator appears to promote adaptive remodeling with enhanced bone formation as part of an adaptive biological response. The morphological and functional changes of the maxillofacial region observed in this clinical case indicate the need for further refinement of current principles and approaches to orthodontic management in this patient population.

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