Osteochondroma of the Jaw: Symptoms, Diagnosis, and Treatment

Osteochondroma (exostosis) is a benign cartilage-capped bony projection. In the jaw, it most often arises from the mandibular condyle or ramus; maxillary involvement is rare.

Symptoms

• Asymptomatic, discovered incidentally on imaging.
• Facial asymmetry, jaw deviation.
• Pain, clicking, limited opening (TMJ dysfunction).
• Malocclusion, difficulty chewing/speaking.
• Rare: nerve compression (inferior alveolar nerve → numbness).

Diagnosis

Panoramic radiograph, CBCT, or MRI shows pedunculated or sessile lesion with cartilage cap. Biopsy rarely needed.

Treatment

• Observation if asymptomatic and not growing (serial imaging).
• Surgical excision for symptoms, functional impairment, cosmetic concern, or malignancy suspicion (cartilage cap >1.5–2 cm in adults).
• Condylectomy with reconstruction if condyle involved.

Malignant transformation to chondrosarcoma is <1% in solitary lesions; higher in multiple hereditary exostoses.