Comparison of the clinical effects of treatment of osteochondroma by two types of vertical ramus osteotomy.

The purpose of this retrospective study was to evaluate 10 patients with osteochondroma of the mandibular condyle who were treated by vertical ramus osteotomy. Three patients had resection of the condyle and reconstruction with free vertical ramus osteotomy grafts (free graft group) and seven had pedicled vertical sliding ramus osteotomy grafts (pedicled graft group). The mean (range) observation period was 30 months. All patients had satisfactory clinical outcomes, and facial symmetry and good occlusion were achieved during the first 10 months. However, slight facial asymmetry was observed in patients treated by free grafts at 11 months, as the mandible deviated to the operated side when the mouth was opened. Postoperative radiographs showed varying degrees of neocondylar resorption and reduction in height. Patients treated with pedicled grafts did not develop these symptoms, and had no bony resorption to speak of on radiographs taken during the follow-up period. In conclusion, the advantages of the pedicled graft over the free graft include less bony resorption and better long-term clinical outcomes.