TMJ Condylar Hyperplasia (CH): Is Proportional Condylectomy Appropriate?

Objectives: It is agreed upon that high condylectomy stops the excessive growth of the condyle in CH. The remaining question is at what level should we perform it. One suggestion is simply high condylectomy. Another possibility is "proportional condylectomy" , namely, cutting the affected condyle to the level of the healthy one, which is intended to encourage remodelling. Our purpose is to challenge this approach.

Methods: Twenty cases are presented describing various types of asymmetries with a variety of malocclusions. We suggest an alternative approach "adaptable condylectomy" that takes into consideration the patient occlusion. The level of condylectomy is adapted to the patient occlusion aiming to keep it in case it is normal and correct the acquired malocclusion caused by the hyperplasia.

Results: In all cases, "adaptable condylectomy" only with no further intervention had resulted in a symmetric face that did not require further intervention. We were able to keep the occlusion in case they were normal and correct the acquired malocclusion caused by the hyperplasia.

Conclusion: "Adaptable condylectomy" should be considered in cases of CH.