The clinical characteristics of condylar hyperplasia: experience with 61 patients

Much reported variation and discord exist regarding mandibular condylar hyperplasia (CH). This study evaluated some of the characteristics of this disorder in a series of 61 patients with active CH.

A total of 61 patients with active temporomandibular CH who had been evaluated in our departments were included. Demographic, clinical, radiologic, and bone scintiscan data were collected and analyzed. Asymmetries were classified as transverse, vertical, or combined.

CH was diagnosed during the growth period in 22 patients, and 39 patients were older than 20 years (range, 11 to 80 years). In 66% of the patients, the main complaint was progressive facial asymmetry; and in the remainder, the main complaint was pain, dysfunction, or both. Transverse asymmetry predominated (52%), and vertical or combined asymmetry occurred in 31% and 16% of patients, respectively; asymmetry type was independent of age. The occlusal plane deviated in 48% of the patients. Laterality was significantly gender-biased (females, 72% right; males, 64% left; P = .017). The condylar head shape was normal in 15% of patients, deformed in 27%, and enlarged in 58%; the condylar neck was elongated in 69% and enlarged in 19%. All of these changes were uncorrelated with the type of asymmetry (vertical, transverse, or combined).

CH may occur at any age and is more prevalent in females. Clinicians should be aware that only some patients complain primarily of facial asymmetry, and that symptoms of temporomandibular disease also may be present. Because there is no correlation between the radiologic findings and the clinical evaluation, classification should be simplified and based on clinical manifestation only--in other words, the direction of asymmetry.