Korean J Orthod.  2020 Mar;50(2):136-144. 10.4041/kjod.2020.50.2.136.

Growth observation and orthodontic treatment of a hemifacial microsomia patient treated with distraction osteogenesis

Affiliations
  • 1Department of Orthodontics, School of Dentistry, Chonbuk National University, Jeonju, Korea. kjgortho@jbnu.ac.kr
  • 2Institute of Oral Biosciences, School of Dentistry, Chonbuk National University, Jeonju, Korea.
  • 3Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.

Abstract

Hemifacial microsomia (HFM) patients may experience emotional withdrawal during their growth period due to their abnormal facial appearance. Distraction osteogenesis at an early age to improve their appearance can encourage these patients. Some abnormalities of the affected side can be overcome by distraction osteogenesis at an early age. However, differences in the growth rate between the affected and unaffected sides during the rest of the growth period are inevitable due to the characteristics of HFM. Therefore, re-evaluation should be performed after completion of growth in order to achieve stable occlusion through either orthognathic surgery or camouflage orthodontic treatment. An eight-year-old patient visited the clinic exhibiting features of HFM with slight mandibular involvement. He received phase I treatment with distraction osteogenesis and a functional appliance. Distraction osteogenesis was performed at the right ramus, which resulted in an open bite at the right posterior dentition. After distraction osteogenesis, a functional appliance and partial fixed appliance were used to achieve extrusion of the affected posterior dentition and settlement of the occlusion adjustment on the unaffected posterior dentition. The patient visited the clinic regularly for follow-up assessments, and at the age of 20 years, he showed facial asymmetry of the mandible, which had deviated to the right side. He received orthodontic treatment to improve the occlusion of his posterior dentition after the growth period. Without orthognathic surgery, stable occlusion and a satisfactory facial appearance were obtained through camouflage orthodontic treatment.

Keyword

Distraction osteogenesis; Hemifacial microsomia

MeSH Terms

Dentition
Facial Asymmetry
Follow-Up Studies
Goldenhar Syndrome*
Humans
Mandible
Open Bite
Orthognathic Surgery
Osteogenesis, Distraction*
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