Proportional Condylectomy as a Single Treatment for Condylar Hyperplasia Asymmetry

Condylar hyperplasia is a major cause for mandibular asymmetry. Traditional treatment includes high condylectomy for an active process, in order to remove the deranged growth center which reside in the articular cartilage, followed by orthognathic surgery, with the goal to regain esthetics and occlusion. In 2014 Wolford et al. introduced a new classification for conditions causing condylar hyperplasia and based on histological findings, he suggested low condylectomy for cases with vertical growth pattern, in view of the existence of cartilaginous islands in the subcortical bone, followed by orthognathic surgery. In 2015 Farina et al. described the use of low condylectomy as the sole treatment for active condylar hyperplasia, with the removal of a segment in proportion to the healthy side, thus achieving spontaneous esthetic improvement. Occlusal relationship was obtained by orthodontic and elastic therapy.

The aims of our study are to investigate whether patients with active condylar hyperplasia, that were treated by 'proportional condylectomy', exhibit spontaneous dentoalveolar reverse compensatory process, thus obviating the need for orthodontic treatment, to observe patients' satisfaction with regard to function and esthetics and to compare their level of satisfaction and symmetry with patients who were diagnosed with arrested condylar hyperplasia and were treated by orthognathic surgery.