Multidisciplinary approach to occlusal rehabilitation in a patient with true hemifacial hyperplasia and temporomandibular joint ankylosis: a case report

This case report details a true hemifacial hyperplasia with temporomandibular joint ankylosis case managed through a multidisciplinary approach involving department of oral and maxillofacial surgery, orthodontics, and prosthodontics. A 42-year-old female patient presented with a chief complaint of limited mouth opening. Clinically, the patient exhibited severe facial asymmetry due to hyperplasia of the left facial region. Cone-beam computed tomography findings revealed overgrowth of the left mandible, zygomatic bone, and maxillary bone including alveolar bone, along with bony ankylosis of the temporomandibular joint. To alleviate the restricted mouth opening, gap arthroplasty was initially performed. Additionally, alveoloplasty was carried out to address occlusal interference caused by the overgrown alveolar bone. Orthodontic treatment was conducted to reduce mandibular molar width and achieve proper overjet. For reconstruction of the left side occlusion, dental implants were placed using an implant surgical guide, followed by prosthetic rehabilitation. Total treatment duration was 48 months, resulting in stabilization of the patient's occlusion. By setting feasible goals through consultations among specialists from each department, based on three-dimensional simulations, successful and efficient occlusal rehabilitation can be achieved in a true hemifacial hyperplasia patient.