Condylectomy is the treatment of choice for patients who present active condylar hyperplasia. The authors have worked with a treatment algorithm for this condition that basically is sustained in the functional matrix theory for more than 15 years with good stable results. Long-term stable results of this protocol were presented in 2011 during the 20th ICOMS. Occlusal stability needs some source of skeletal stability, most likely condylar remodulation. Observation of the long-term records showed condylar enlargement. In those cases where functional occlusion was also achieved, the head of the condyle was similar a new normal condyle. With this background, we decided to perform this prospective study.

Objectives: To create the correct mandibular and occlusal functional matrix to have the condylar stump growing as the new condylar head.

Methods: 10 patients were included. All of them underwent the author’s diagnostic and treatment protocol, but including a follow up with CBCT scanner to follow this new growth at the condylar head. The protocol of treatment included pre surgical orthodontics for a tridimensional correction of the skeletal asymmetry through orthognathic surgery followed for immediate condylectomy and active physiotherapy for as long as the patient need to obtain full range of mandibular motion along with post surgical orthodontic treatment to get functional stable occlusion.

Results: All 10 patients included in this study showed a new condylar head which grew toward the space being left at the time of surgery and preserved with active physiotherapy and the correct functional occlusal relationships.

Conclusions: Horizontalization of the occlusal plane is a key issue in the tridimensional correction of the skeletal asymmetry. Functional occlusion is also essential and with these two pillars, active physiotherapy gives the patients the correct functional matrix to create a new condylar head after mandibular condylectomy.