{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T17:01:05Z","timestamp":1775062865955,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health, Current research IRCCS"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Unilateral condylar hyperplasia is an idiopathic condition that causes facial asymmetry and occlusal problems. Currently, traditional treatment protocol is the combination of orthognathic and extra-oral condylectomy surgery via pre-auricular incision, which can create aesthetic problems with additional risks of facial nerve damage. The purpose of this study was to report management of condylar hyperplasia patients through minimally invasive condylectomy that was planned via virtual methods. Methods: The custom-made cutting guides were produced, and unilateral condylectomy operations were performed via intra-oral approach. Orthognathic surgery with\/without genioplasty operations were either done with condylectomy in one session or in an additional session. Results: Custom-made cutting guides produced by virtual methods provided easy operations without any need for additional extra-oral incisions. Planned osteotomies were transferred successfully from the virtual surgical plan and resections of the excess bone tissues were performed using novel piezo surgery devices. The bones were fixed to their pre-planned position using 3D-printed titanium plates. The patients healed without any complications. Results of this innovative virtually guided protocol tested showed functional and esthetic results without any extra-oral scars with no facial nerve damage. Conclusions: Combination of intra-oral condylectomy with orthognathic surgery using 3D-printed titanium cutting guides seems to be an advantageous approach with successful results in terms of aesthetics and function for management of mandibular condylar hyperplasia patients; however, there is an urgent need in the scientific literature for further clinical research with a larger number of subjects.<\/jats:p>","DOI":"10.3390\/jcm15072671","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T14:59:01Z","timestamp":1775055541000},"page":"2671","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Minimally Invasive Protocol for the Management of Unilateral Condylar Hyperplasia: Case Series on Seven Patients"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2354-361X","authenticated-orcid":false,"given":"Funda","family":"Goker","sequence":"first","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"},{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul Ayd\u0131n University, 34295 Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Hamaui","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Tirelli","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5983-9674","authenticated-orcid":false,"given":"Aldo Bruno","family":"Gianni","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca Martino","family":"Tartaglia","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0198-748X","authenticated-orcid":false,"given":"Sourav","family":"Panda","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha O Anusandhan University, Bhubaneswar 751030, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7144-0984","authenticated-orcid":false,"given":"Massimo","family":"Del Fabbro","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2652-1993","authenticated-orcid":false,"given":"Diego Sergio","family":"Rossi","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1016\/j.jcms.2017.04.007","article-title":"Efficacy of proportional condylectomy in a treatment protocol for unilateral condylar hyperplasia: A review of 73 cases","volume":"45","author":"Mouallem","year":"2017","journal-title":"J. Cranio-Maxillofac. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.joms.2007.08.046","article-title":"The clinical characteristics of condylar hyperplasia: Experience with 61 patients","volume":"66","author":"Nitzan","year":"2008","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e685","DOI":"10.1097\/SCS.0000000000008558","article-title":"Precise Intraoral Condylectomy With the Guide of Three-Dimensional Printed Template in a Mandibular Condylar Hyperplasia Patient","volume":"33","author":"Yuan","year":"2022","journal-title":"J. Craniofacial Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1097\/SCS.0000000000006054","article-title":"Unilateral Condylar Hyperplasia: A Comparison with Two Open-Source Softwares","volume":"31","author":"Vellone","year":"2020","journal-title":"J. Craniofacial Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1016\/j.ijom.2020.06.015","article-title":"Minimally invasive intraoral proportional condylectomy with a three-dimensionally printed cutting guide","volume":"49","year":"2020","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1016\/j.jcms.2018.04.028","article-title":"Unilateral hemimandibular hyperactivity: Clinical features of a population of 128 patients","volume":"46","author":"Vernucci","year":"2018","journal-title":"J. Cranio-Maxillofac. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.ijom.2010.09.015","article-title":"Bone scintigraphy as a diagnostic method in unilateral hyperactivity of the mandibular condyles: A review and meta-analysis of the literature","volume":"40","author":"Saridin","year":"2011","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/S0301-0503(86)80290-9","article-title":"Hemimandibular hyperplasia\u2013hemimandibular elongation","volume":"14","author":"Obwegeser","year":"1986","journal-title":"J. Maxillofac. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e227569","DOI":"10.1136\/bcr-2018-227569","article-title":"Review and Classification Update: Unilateral condylar hyperplasia","volume":"12","author":"Arora","year":"2019","journal-title":"BMJ Case Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1016\/j.ijom.2016.04.001","article-title":"Minimally invasive intraoral condylectomy: Proof of concept report","volume":"45","year":"2016","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2227","DOI":"10.1097\/SCS.0b013e31823200da","article-title":"Three-dimensional analysis and treatment planning of hemimandibular hyperplasia","volume":"22","author":"Pelo","year":"2011","journal-title":"J. Craniofacial Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.joms.2010.04.025","article-title":"Hyperplasia of the mandibular condyle: Clinical, histopathologic, and treatment considerations in a series of 36 patients","volume":"69","author":"Monje","year":"2011","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1007\/s10006-011-0310-9","article-title":"Conservative management of unilateral condylar hyperplasia","volume":"16","author":"Rajkumar","year":"2012","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1097\/SCS.0000000000000699","article-title":"Surgical treatment of unilateral condylar hyperplasia with piezosurgery","volume":"25","author":"Chiarini","year":"2014","journal-title":"J. Craniofacial Surg."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Smolka, W., Cornelius, C.P., Obermeier, K.T., Otto, S., and Liokatis, P. (2025). Proportional Condylectomy Using a Titanium 3D-Printed Cutting Guide in Patients with Condylar Hyperplasia. Craniomaxillofac. Trauma Reconstr., 18.","DOI":"10.3390\/cmtr18010007"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/s12663-024-02205-5","article-title":"Virtual Planning a Leading Edge for Facial Asymmetry Following Left Unilateral Condylar Hyperplasia: Case Report","volume":"24","author":"Edward","year":"2025","journal-title":"J. Maxillofac. Oral Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e251","DOI":"10.1097\/SCS.0000000000010789","article-title":"Proportional Condylectomy for the Treatment of Unilateral Condylar Hyperplasia with Maloclussion: Role of Point-of-Care Manufacturing Surgical Guides and Intraoperative Computed Tomography to Avoid Secondary Orthognatic Surgery","volume":"36","author":"Tousidonis","year":"2025","journal-title":"J. Craniofacial Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1097\/SCS.0000000000009778","article-title":"The Role of Digital Surgical Planning and Surgical Guides in the Treatment of Unilateral Condylar Hyperplasia","volume":"35","author":"Figueroa","year":"2024","journal-title":"J. Craniofacial Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"227","DOI":"10.5125\/jkaoms.2024.50.4.227","article-title":"Surgery-early approach combined with condylectomy for correction of severe facial asymmetry with mandibular condylar hyperplasia: A case report","volume":"50","author":"Suzuki","year":"2024","journal-title":"J. Korean Assoc. Oral Maxillofac. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Su, L., Kang, Y., Guo, C., and Wang, X. (2025). Analysis of Dynamic Mandibular Movement of Patients with Condylar Hyperplasia Treated with Orthognathic Surgery and Condylectomy. J. Craniofacial Surg., Advance online publication.","DOI":"10.1097\/SCS.0000000000011083"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Olate, S., Ravelo, V., Alister, J.P., Netto, H.D., Haidar, Z.S., and Sacco, R. (2023). Early Treatment of Unilateral Condylar Hyperplasia in Adolescents: Preliminary Results. J. Clin. Med., 12.","DOI":"10.3390\/jcm12103408"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1111\/adj.70020","article-title":"Digital Diagnostics and Treatment Planning for Orthognathic Surgery","volume":"70","author":"Li","year":"2025","journal-title":"Aust. Dent. J."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Tsokkou, S., Konstantinidis, I., Keramas, A., Kiosis, G., Skourtsidis, K., Alexiou, D., Keskesiadou, G.N., Karachrysafi, S., Papamitsou, T., and Chatzistefanou, I. (2025). Comparative Analysis of Fully Guided and Free-Hand Orthognathic Surgery: Advancements, Precision, and Clinical Outcomes. Dent. J., 13.","DOI":"10.3390\/dj13060260"},{"key":"ref_24","first-page":"62","article-title":"Analysis and comparison of quality of life and patients\u2019 satisfaction between dental-skeletal dysmorphisms and Obstructive Sleep Apnea (OSA) patients following orthognathic surgery","volume":"26","author":"Rossi","year":"2022","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2463","DOI":"10.1016\/j.radcr.2025.01.079","article-title":"A facial asymmetry revealed: Active mandibular condylar hyperplasia","volume":"20","author":"Guennouni","year":"2025","journal-title":"Radiol. Case Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"46","DOI":"10.12688\/f1000research.48499.1","article-title":"Case Report: Unilateral condylar hyperplasia","volume":"10","author":"Shetty","year":"2021","journal-title":"F1000Res"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2080","DOI":"10.1016\/j.joms.2020.06.010","article-title":"Titanium Alloy Cutting Guides in Craniomaxillofacial Surgery-A Minimally Invasive Alternative to Synthetic Polymer Guides","volume":"78","author":"Gigliotti","year":"2020","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"104519","DOI":"10.1016\/j.jcms.2026.104519","article-title":"Functional and psychosocial outcomes of simultaneous condylectomy and bimaxillary orthognathic surgery for unilateral condylar hyperplasia: Retrospective study","volume":"54","author":"Varol","year":"2026","journal-title":"J. Cranio-Max. Fac. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.ijom.2021.04.007","article-title":"The need for secondary orthognathic surgery after high condylectomy in patients with active unilateral condylar hyperplasia","volume":"51","author":"Aerden","year":"2022","journal-title":"Int. J. Oral Max. Fac. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/7\/2671\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T15:11:55Z","timestamp":1775056315000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/7\/2671"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,1]]},"references-count":29,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["jcm15072671"],"URL":"https:\/\/doi.org\/10.3390\/jcm15072671","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,1]]}}}