Hyperplasia of the mandibular condyle: clinical, histopathologic, and treatment considerations in a series of 36 patients.
OBJECTIVE
Mandibular condylar hyperplasia (CH) is a rare entity that causes overdevelopment of the mandible, creating functional and esthetic problems. The aim of this article was to describe demographic and clinical characteristics of CH, analyze histopathologic features and their association with scintigraphic and clinical findings, and evaluate esthetic and functional results after treatment by high condylectomy during the active phase.


METHODS
This retrospective study included 36 patients whose condyles were removed because of excessive unilateral growth resulting in facial asymmetry and occlusal disturbance. Of the 36 patients, 13 had had symptoms related to the temporomandibular joint, such as pain or clicking. In all the cases, high condylectomy was performed, and surgical specimens were sent for histologic examination and divided into 4 histologic types as described by Slootweg and Müller. Statistical analysis was performed by use of R software (version 2.10.1; R Foundation for Statistical Computing, Vienna, Austria) and SPSS software for Windows (version 15.0; SPSS, Chicago, IL) to evaluate our results. A χ(2) test was carried out to assess the possible association between gender and involved side. The association of histologic appearance with clinical symptoms was estimated by use of the Fisher exact test. An analysis of variance test was performed to evaluate a possible association between patient age and histologic type according to the Slootweg and Müller classification and between histologic type and uptake on bone single photon emission computed tomography (SPECT).


RESULTS
We could not find a relationship between histologic type and uptake of the affected condyle on bone SPECT or between age and histologic type. However, our statistical analysis revealed an association between histologic appearance and the presence of joint symptoms (P = .0049). Clinically, occlusion and facial symmetry improved in all patients postoperatively, and no recurrence was noted in any patient. Six patients required secondary surgery.


CONCLUSIONS
We could not find any significant association between age and histologic type or between bone SPECT and histologic type. However, a significant association between histologic type and temporomandibular joint symptoms was observed. High condylectomy combined with orthodontics achieved optimal esthetic and functional results and constituted the unique and definitive treatment in 30 of 36 patients.
Villanueva-Alcojol
Laura
L
Department of Oral and Maxillofacial-Head and Neck Surgery, University Hospital Infanta Cristina, Badajoz, Spain. laurivillanueva@hotmail.com
Monje
Florencio
F
González-García
Raúl
R
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D004954:Esthetics; D005081:Exercise Therapy; D005146:Facial Asymmetry / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008310:Malocclusion / Q000209:etiology / Q000601:surgery; D008335:Mandibular Condyle / Q000473:pathology* / Q000601:surgery; D009971:Orthodontics, Corrective; D010027:Osteotomy / Q000379:methods; D011862:Radiography, Panoramic; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D012737:Sex Factors; D013705:Temporomandibular Joint Disorders / Q000209:etiology / Q000601:surgery; D015899:Tomography, Emission-Computed, Single-Photon; D055815:Young Adult