Efficacy of proportional versus high condylectomy in active condylar hyperplasia - A systematic review.

Objective: To perform a systematic literature review to test the efficacy of proportional condylectomy versus high condylectomy in patients with active condylar hyperplasia, in terms of avoiding secondary surgeries.

Method: Following a search of Medline (Pubmed), Embase, Scopus, Web of Science and Cochrane databases, ten studies were included for qualitative analysis, and two studies were included for meta-analysis. Quality assessment was performed using the Newcastle-Ottawa scale for cohort studies and the 18-item modified Delphi technique for case series.

Results: 259 patients were included in the qualitative analysis, with a weighted arithmetic mean age of 20.4 years, and a female:male ratio of 2:1. Meta-analysis was carried out for 52 patients, and it was found that proportional condylectomy reduced the need for secondary surgery (p = 0.0003). Although this evidence had limitations, excised bone on proportional condylectomy was superior when compared with excised bone on high condylectomy, re-establishing the occlusal plane, resulting in fewer asymmetries, and therefore reducing the need for further surgery.

Conclusions: This systematic review showed a tendency for proportional condylectomies to avoid additional surgeries; however, more comparative studies are necessary.