A Better Understanding of Unilateral Condylar Hyperplasia of the Mandible.

PURPOSE: Our current understanding of unilateral condylar hyperplasia (UCH) was put forth by Obwegeser. He hypothesized that UCH is 2 separate conditions: hemimandibular hyperplasia and hemimandibular elongation. This hypothesis was based on the following 3 assumptions: 1) the direction of overgrowth, in UCH, is bimodal-vertical or horizontal, with rare cases growing obliquely; 2) UCH can expand a hemimandible with and without significant condylar enlargement; and 3) there is an association between the condylar expansion and the direction of overgrowth-minimal expansion resulting in horizontal growth and significant enlargement causing vertical displacement. The purpose of this study was to test these assumptions. PATIENTS AND METHODS: We analyzed the computed tomography scans of 40 patients with UCH. First, we used a Silverman Cluster analysis to determine how the direction of overgrowth is distributed in the UCH population. Next, we evaluated the relationship between hemimandibular overgrowth and condylar enlargement to confirm that overgrowth can occur independently of condylar expansion. Finally, we assessed the relationship between the degree of condylar enlargement and the direction of overgrowth to ascertain if condylar expansion determines the direction of growth. RESULTS: Our first investigation demonstrates that the general impression that UCH is bimodal is wrong. The growth vectors in UCH are unimodally distributed, with the vast majority of cases growing diagonally. Our second investigation confirms the observation that UCH can expand a hemimandible with and without significant condylar enlargement. Our last investigation determined that in UCH, there is no association between the degree of condylar expansion and the direction of the overgrowth. CONCLUSIONS: The results of this study disprove the idea that UCH is 2 different conditions: hemimandibular hyperplasia and hemimandibular elongation. It also provides new insights about the pathophysiology of UCH.

Karl Pearson and eugenics: personal opinions and scientific rigor.

The influence of personal opinions and biases on scientific conclusions is a threat to the advancement of knowledge. Expertise and experience does not render one immune to this temptation. In this work, one of the founding fathers of statistics, Karl Pearson, is used as an illustration of how even the most talented among us can produce misleading results when inferences are made without caution or reference to potential bias and other analysis limitations. A study performed by Pearson on British Jewish schoolchildren is examined in light of ethical and professional statistical practice. The methodology used and inferences made by Pearson and his coauthor are sometimes questionable and offer insight into how Pearson's support of eugenics and his own British nationalism could have potentially influenced his often careless and far-fetched inferences. A short background into Pearson's work and beliefs is provided, along with an in-depth examination of the authors' overall experimental design and statistical practices. In addition, portions of the study regarding intelligence and tuberculosis are discussed in more detail, along with historical reactions to their work.