Condylar Hyperactivity, Hyperplasia or Hypertrophy? A Comprehensive Guide to Nomenclature and Surgical Techniques

Unilateral condylar hyperactivity (UCH) has many different definitions in the literature. Still, one of the most encompassing definitions describes it as a condition with increased bone-cell activity of one mandibular condyle, resulting in growth-resembling progressive mandibular asymmetry of unknown etiology occurring over an uncertain period of time and at an uncertain rate in patients with varying age ranges, lacking a gold standard. During the last few years, different classifications have been proposed for UCH. Within the classification of condylar pathologies, mandibular condyle hyperplasia takes the centre stage. However, hyperactivity of the condyle becomes paramount in establishing a diagnosis and selecting the most appropriate treatment course. Despite the frequent misunderstanding between terms such as condylar hyperactivity, hyperplasia, and hypertrophy, understanding the nuances of each is crucial for accurate diagnosis and effective treatment. The advancements in classification systems—from Obwegeser and Makek’s to the Wolford system—have significantly improved our ability to categorize and manage UCH. Surgical interventions like the proportional condylar reduction, particularly when guided by advanced imaging techniques, offer promising outcomes for patients with mandibular asymmetry.