Indian Journal of Dental ResearchIndian Journal of Dental ResearchIndian Journal of Dental Research
Indian Journal of Dental Research   Login   |  Users online:

Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size         


Table of Contents   
Year : 2011  |  Volume : 22  |  Issue : 4  |  Page : 616
Osteochondroma of the mandibular condyle

1 Department of Community Dentistry, BJS Dental College, Punjab University, Ludhiana, India
2 Private Practice, Oral and Maxillofacial Surgery and Oral Implantolgy, Mumbai, Maharashtra, India
3 Department of Periodontics and Oral Implantology, Dr. D. Y Patil Dental College, Mumbai, Maharashtra, India
4 Head of Dental Wing, Muzaffarnagar Medical College, CCS University, Muzaffarnagar (UP), India

Click here for correspondence address and email

Date of Submission01-Dec-2010
Date of Decision07-Dec-2010
Date of Acceptance23-Feb-2011
Date of Web Publication26-Nov-2011


Osteochondroma (OC) of the mandibular condyle is a relatively rare condition that causes a progressive enlargement of the condyle, usually resulting in facial asymmetry, temporomandibular joint (TMJ) dysfunction, and malocclusion. Radiographically, there is a unilaterally enlarged condyle usually with an exophytic outgrowth of the tumor from the condylar head. We present a case of a left mandibular condylar OC that created a major facial asymmetry, malocclusion, and TMJ dysfunction. Discussion includes the rationale for treatment and the method used in this case. In actively growing OCs, surgical intervention is indicated to remove the tumor stopping the benign growth process and improve facial symmetry, occlusion, and jaw function.

Keywords: Mandibular dysfunction, osteochondroma, rationale for treatment

How to cite this article:
Kumar A, Rastogi S, Modi M, Nijhawan S. Osteochondroma of the mandibular condyle. Indian J Dent Res 2011;22:616

How to cite this URL:
Kumar A, Rastogi S, Modi M, Nijhawan S. Osteochondroma of the mandibular condyle. Indian J Dent Res [serial online] 2011 [cited 2022 Dec 6];22:616. Available from:
Osteochondroma (OC) is one of the most common benign tumors of the axial skeleton, but it is rarely present in the facial bones. When present, the tumor most commonly affects the mandibular coronoid process or the mandibular condyle. [1] Symptomatic unilateral enlargements of the mandibular condyle are relatively uncommon. Appreciation of the embryologic development of the temporomandibular joint (TMJ) is important for an understanding of the pathology of this region. Typical facial features of condylar OCs include striking facial asymmetry, malocclusion with open-bite on the affected side, with deviation of the chin, and cross-bite to the contralateral side. [2] Pain and dysfunction often accompany the anatomic derangement. Radiographically, these lesions are radiopaque with distinct borders and easily identified on computed tomography (CT) as well as plain radiography.

Histologically, OC needs to be distinguished from osteoma, benign osteoblastoma, chondroma, and chondroblastoma. The histologic criteria for the diagnosis of an OC include chondrocytes of the cartilaginous cap arranged in clusters in parallel oblong lacunar spaces similar to those of normal epiphysial cartilage. The histologic orientation is suggestive of a benign lesion. Regular bony trabeculae produced by endochondral ossification are present. The exostosis is covered by periosteum that is continuous with that of the adjacent bone.

   Case Report Top

A 55-year-old female patient was referred to our clinic with complaints of eating and speaking difficulties and presenting a facial asymmetry. She had a history of previous TMJ treatment on the left side 10 years ago and from that time on a slowly progressing facial asymmetry with limitation in mouth opening began. Physical examination revealed that there was approximately an 8-mm deviation of midline to the right side [Figure 1]. The patient's maximum mouth opening measured was 32 mm. There was a unilateral posterior cross-bite on the right side and 8 mm negative horizontal overjet. On the panoramic radiograph, the mandibular condyle is displaced out of the fossa and is sitting beneath the articular eminence as a result of the overgrowth of the OC anterior to the articular eminence that has consequently displaced the condyle forward in the fossa [Figure 2]. On the coronal, axial, and 3-dimensional CT images, it was clearly distinguished that there was a cartilaginous/bony lesion developed from the left anterior condylar head [Figure 3] and [Figure 4]. Whole body scintigraphy revealed an increased activity in left TMJ.
Figure 1: Progressive asymmetry of the left side of the face

Click here to view
Figure 2: OPG reveals irregular radiopacity associated with the left condyle

Click here to view
Figure 3: Axial CT scan reveals a radiopaque mass associated with medial border of the left condyle

Click here to view
Figure 4: 3D CT scan shows a dense opaque mass arises from anterior border of the left condyle

Click here to view

Tumor excision was performed under general anesthesia and nasotracheal intubation. Surgical access was through the intraoral vertical ramus incision on the left side and the tumor was excised sparing the coronoid and condyle. Dimensions of the excised tumor were 4 × 3.5 × 3 cm. Histopathologic examination revealed a nodular lesion having cartilaginous cap and mature bone tissue beneath [Figure 5], consistent with OC. Patient recovery was uneventful. The postoperative follow-up examinations revealed no recurrences after five years and maintenance of facial symmetry and joint function.
Figure 5: Histologic section reveals the confirm diagnosis of osteochondroma

Click here to view

   Discussion Top

Condylar OCs are frequently situated on the anteromedial surface of the condylar head. The occurrence of these tumors in the condyle tends to support the theory of aberrant foci of epiphysial cartilage on the surface of the bone. [3] One theory states that stress in the tendinous insertion region of lateral pterygoid muscle, where focal accumulations of cells with cartilaginous potential exist, leads to formation of these tumors. This may also explain the occurrence of the OCs in the coronoid process stressed by the tension of temporalis muscle. [4] Other theories as to the cause include neoplastic, developmental, reparative, and traumatic etiologies. [5] Early occurrence of the unilateral condylar hyperplasia results in gradual deviation of the midline away from the affected side with increased vertical mandibular growth. When growth of the lesion is slow, there is reciprocal compensatory vertical growth of the maxilla with canting of the occlusal plane to accommodate the increasing mandibular vertical dysplasia.

A conservative condylectomy with articular disc repositioning combined with orthognathic surgery is an acceptable option for treatment of condylar OC. [6] Most case reports include no TMJ reconstruction, only tumor removal. For the reconstructed cases, varieties of procedures have been used including condyloplasty, discectomy, costochondral grafting, disc plication, coronoidectomy, eminoplasty, alloplastic spacer placement, Le FortI osteotomy, and extraoral and intraoral vertical ramus osteotomies.

The OC had not invaded the whole condyle in the present case. That is why our conservative approach removed the tumor completely with curetting some intact bone and left the remaining condyle in place. Condylectomy was not our choice of treatment, so no condylar reconstruction or any other adjunctive surgeries were needed.

   Conclusion Top

Due to the distinctive radiographic appearance of mandibular OCs, CT provides an invaluable tool to assist in evaluation and treatment planning. The recommended treatment of choice for symptomatic OCs is surgical resection.

   References Top

1.Lichtenstein L. Bone Tumors, 5 th ed. St Louis; MO, Mosby; 1977. p. 26-30.  Back to cited text no. 1
2.Kurita K, Ogi N, Echiverre NV, Yoshida K. Osteochondroma of the mandibular condyle. A case report. Int J Oral Maxillofac Surg 1999;28:380-2.  Back to cited text no. 2
3.Karras SC, Wolford LM, Cottrell DA. Concurrent osteochondroma of the mandibular condyle and ipsilateral cranial base resulting in temperomandibular joint ankylosis: Report of a case and review of the literature. J Oral Maxillofac Surg 1996;54:640-6.  Back to cited text no. 3
4.Wolford LM, Mehra P, Franco P. Use of conservative condylectomy for treatment of osteochondroma of the mandibular condyle. J Oral Maxillofac Surg 2002;60:262-8.  Back to cited text no. 4
5.Dahlin DC, Unni KK. Bone Tumors. General aspects and data on 8542 cases. Springfield (IL): Charles C. Thomas; 1986. p. 18-32.  Back to cited text no. 5
6.Stevao ELL, Wolford LM, Morales-Ryan CA. Osteochondroma of the mandibular condyle: Conservative reconstruction with condylectomy. J Oral Maxillofac Surg 2003;61:65.  Back to cited text no. 6

Correspondence Address:
Sanjay Rastogi
Private Practice, Oral and Maxillofacial Surgery and Oral Implantolgy, Mumbai, Maharashtra
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-9290.90330

Rights and Permissions


  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]

This article has been cited by
1 Surgical resection of osteochondroma in the mandibular condyle associated with directional orthodontic treatment: review of literature and a case report
A.B. Bachesk, C.F. Sessenta Junior, L. Iwaki Filho
Oral Surgery. 2020; 13(3): 280
[Pubmed] | [DOI]
2 Large Osteochondroma of the Coronoid Process of Left Mandible: Clinical and Imaging Findings of a Rare Case
Ibrahim Sevki Bayrakdar
MOJ Clinical & Medical Case Reports. 2017; 7(2)
[Pubmed] | [DOI]
3 Large Osteochondroma of the Coronoid Process of Left Mandible: Clinical and Imaging Findings of a Rare Case
Ibrahim Sevki Bayrakdar
MOJ Clinical & Medical Case Reports. 2017; 7(2)
[Pubmed] | [DOI]
4 Low Condylectomy and Orthognathic Surgery to Treat Mandibular Condylar Osteochondroma: Retrospective review of 37 cases
Larry M. Wolford,Reza Movahed,Amit Dhameja,Will R. Allen
Journal of Oral and Maxillofacial Surgery. 2014;
[Pubmed] | [DOI]
5 osteochondroma: diagnostic imaging, complications and variants [osteocondroma: diagnóstico radiológico, complicaciones y variantes]
cañete prette, m. and fontoira m., e. and gutiérrez san josé, b. and mancheva m., s.
revista chilena de radiologia. 2013; 19(2): 73-81
6 osteochondroma of mandibular condyle: a clinic-radiographic correlation
more, c.b. and gupta, s.
journal of natural science, biology and medicine. 2013; 4(2): 465-468


    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Email Alert *
    Add to My List *
* Registration required (free)  

   Case Report
    Article Figures

 Article Access Statistics
    PDF Downloaded259    
    Comments [Add]    
    Cited by others 6    

Recommend this journal