Mandibular Condylar Hyperplasia

By Noshir R. Mehta, DMD, MDS, MS, Tufts University School of Dental Medicine

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Temporomandibular Disorders
Overview of Temporomandibular Disorders
Ankylosis of the Temporomandibular Joint (TMJ)
Arthritis of the Temporomandibular Joint (TMJ)
Mandibular Condylar Hyperplasia
Mandibular Condylar Hypoplasia
Internal Temporomandibular Joint Derangement
Myofascial Pain Syndrome

Mandibular condylar hyperplasia is a disorder of unknown etiology characterized by persistent or accelerated growth of the condyle when growth should be slowing or ended. Growth eventually stops without treatment.

Slowly progressive unilateral enlargement of the head and neck of the condyle causes crossbite malocclusion, facial asymmetry, and shifting of the midpoint of the chin toward the unaffected side. The patient may appear prognathic. The lower border of the mandible is often convex on the affected side. Chondroma and osteochondroma (see Benign Bone Tumors and Cysts : Osteochondroma) may cause similar symptoms and signs, but they grow more rapidly and may cause even greater asymmetric condylar enlargement.

Diagnosis

Plain x-rays
Usually CT

On plain x-rays, the temporomandibular joint may appear normal, or the condyle may be proportionally enlarged and the mandibular neck elongated. CT is usually done to determine whether bone growth is generalized, which confirms the diagnosis, or localized to part of the condylar head. If growth is localized, a biopsy may be necessary to distinguish between tumor and hyperplasia.

Treatment

During active growth, usually condylectomy
After growth cessation, orthodontics followed by surgical mandibular repositioning

Treatment usually includes condylectomy during the period of active growth. If growth has stopped, orthodontics and surgical mandibular repositioning are indicated. If the height of the mandibular body is greatly increased, facial symmetry can be further improved by reducing the inferior border.

Last full review/revision December 2014 by Noshir R. Mehta, DMD, MDS, MS