What happens to the contralateral condyle after proportional condylectomy? A multicenter study

Objective This retrospective study evaluated 3D positional and volumetric adaptations of the contralateral condyle after proportional condylectomy performed alone or combined with orthognathic surgery.Methods Twenty-three patients were allocated into three groups: isolated proportional condylectomy (G1), simultaneous condylectomy and orthognathic surgery (G2), and staged treatment (G3). CBCT analysis used anatomical landmarks, and condylar volume was assessed by semi-automated reconstruction.Results Median follow-up was 12.1, 9.7, and 13.3 months for G1, G2, and G3, respectively (7.7 months for T1–T2 in G3). G1 showed no significant positional changes. G2 exhibited superomedial rotational adaptation, with superior (0.5 mm, p = .01) and medial (1.5 mm, p = .04) displacements and lateral displacement of −0.5 mm (p = .048). G3 showed linear medial displacement of 2.6 mm (p=.04). No significant volumetric changes occurred in any group.Conclusion Distinct short-term 3D adaptation patterns of the contralateral condyle occurred according to surgical strategy. Volumetric changes were modest, suggesting adaptive remodeling rather than pathological resorption.