CONDYLECTOMY IN THE TREATMENT OF CONDYLAR HYPERPLASIA: INDICATION CRITERIA, POSTOPERATIVE STABILITY, AND IMPACT ON MANDIBULAR FUNCTION

Abstract

Condylar hyperplasia (CH) is a rare condition characterized by asymmetric growth of the mandibular condyle, leading to progressive facial asymmetry, occlusal disturbances, and functional impairment of the temporomandibular joint (TMJ). Condylectomy, either alone or combined with orthognathic surgery, remains one of the main surgical strategies to arrest active condylar growth and correct the resulting dentofacial deformity. This review aimed to analyze the scientific evidence produced between 2021 and 2026 regarding the indication criteria for condylectomy, the postoperative stability achieved, and the procedure's impact on mandibular function. A narrative literature review was conducted, with a non-systematic search carried out in September 2026, prioritizing publications indexed in PubMed/MEDLINE and available on open-access platforms, without prior protocol registration, peer screening, or formal risk-of-bias assessment of the included studies. The evidence indicates that determining condylar activity through bone scintigraphy and SPECT/SPECT-CT remains the main criterion for distinguishing active from inactive hyperplasia and guiding surgical timing. In a non-randomized comparison specifically involving proportional condylectomy, this technique achieved improvements in facial and occlusal parameters and patient satisfaction similar to those observed in a distinct group treated with isolated orthognathic surgery, a finding that cannot be generalized to all condylectomy techniques. Protocols combining condylectomy and orthognathic surgery in a single stage have been described with satisfactory occlusal stability in case series without a comparator group, which does not support claims of a proven reduction in the need for reintervention relative to other protocols. Quality-of-life and mandibular function instruments show consistent improvement after surgical treatment, although some patients retain residual limitations in mouth opening or mild joint symptoms. It is concluded that condylectomy, when carefully indicated and associated with multidisciplinary follow-up, constitutes an approach with potential efficacy for managing condylar hyperplasia, and standardization of diagnostic criteria, controlled comparative studies, and longitudinal monitoring of mandibular function are recommended.