Facial asymmetry secondary to aplasia of the mandibular condyle

Growth disturbances in the mandibular condyle region include aplasia, hypoplasia and hyperplasia. Aplasia of the mandibular condyle may occur following a history of trauma, with an underlying pathological disorder or with any syndromic association. We present here a case of a 16 year old female presenting with profound facial asymmetry since childhood without association of any syndrome. The first clinical impression of the patient was that of residual facial asymmetry following release of unilateral TMJ ankylosis considering the fullness on one side and flattened face on the other side. Digital orthopantomogram and CT scan revealed a complete absence of condyle on the right side Scintigraphy revealed reduced tracer uptake on right side. Patient was diagnosed with Aplasia of condyle on right side. Considering the patients’ age and skeletal maturity, patient is kept under observation. Treatment options include a multidisciplinary approach viz orthodontic treatment, radiological evaluation of skeletal growth and a surgical intervention with a concept of neo-condyle formation via distraction osteogenesis. Surgical camouflage via an implant placement for esthetic facial rehabilitation proves to be an excellent treatment option with minimal morbidity.