Orthopedically Induced Condylar Growth in a Patient with Hemifacial Microsomia

Abstract

Objective Hemifacial microsomia is a congenital abnormality that causes three-dimensional facial asymmetry, affection of the dental occlusion, and failure of growth of the midface in the growing child. This report outlines orthopedically induced condylar growth in a patient with hemifacial microsomia. Patient A 7-year-old girl with hemifacial microsomia, complete absence of the left mandibular condyle, and severe facial asymmetry was treated orthopedically in an early stage by means of a functional appliance. Functional therapy was instituted to stretch the deficient soft tissues to guide and promote skeletal growth and stimulate the affected areas. The treatment was completed with fixed appliances. Results The effect of the therapy was an excessive change in condylar growth in the affected side. Facial asymmetry was corrected and a symmetric mouth opening was established. Conclusions The treatment of patients with hemifacial microsomia should be initiated early enough so that the stimulus could in some degree normalize the deficient tissues and induce bone apposition, and in some cases surgical intervention could be avoided.

Aneurysmal Bone Cyst located in the Mandibular Condyle

“…Moreover the functional device Bionator is expected to stimulate the operated right side of the mandible for an additional growing. There is a vast documentation how functional appliances are used for hemifacial microsomia with excellent results [ 20 ]. The condyle and the ramus of the mandible have great potential of growing if opportunely stimulated [ 21 ].…”

Dental and maxillofacial features of condylo-mandibular dysplasia: A case series of 21 patients

“…Various examples of the deformation can be found in the literature. These are described as cases of hemifacial microsomia with a good response to orthodontic treatment (Figueroa et al, 1984;Kaplan, 1989;Melsen et al, 1986;Sidiropoulou et al, 2003;Silvestri et al, 1996;Kahl-Nieke and Fischbach, 1998). Various books have also documented these misdiagnosed cases of hemifacial microsomia with typical radiographic presentations of condylo-mandibular dysplasia (Bell, 1992;Booth et al, 1999;Tessier, 2001).…”

“…There have been very few reports to date of condylomandibular dysplasia in the literature. As highlighted by , a casual example of condylo-mandibular dysplasia was published in the form of 'misdiagnosed' hemifacial microsomia, characterized by successful orthodontic treatment despite substantial condyle deformities (Figueroa et al, 1984;Kaplan et al, 1989;Melsen et al, 1986;Sidiropoulou et al, 2003;Silvestri et al, 1996;Kahl-Nieke and Fischbach, 1998). The main differences between condylomandibular dysplasia and craniofacial microsomia are the permanent absence of soft-tissue involvement and a normal appearance of the ears (Meazzini et al, 2011).…”

Temporomandibular Joint Dysplasia in Cranio-Maxillofacial Dysplasia: A Retrospective Study. Guideline Treatment Proposal

“…Costochondral Graft (Cases 1,2,5,8,10,14, 15,19,32,35,41,42,48,57,60,62,64) Because of a lack of growth in many cases of CMD, surgeons have tried to develop techniques that could treat this deficit. The costochondral graft is one of these methods.…”

“…Dentofacial orthopedic devices are often used in CMD. 32,33 They can provide good results even in extreme cases but they are inconstant depending on the patients' assiduity, experience of the practioner, and the type of defect. [34][35][36] Many speculations have been made on the effects of functional appliances in CMD.…”