Chung Nam Hyung, Yang So Jin, Kang Jae Yoen, Jeon Young-Mi, Kim Jong Ghee
Department of Orthodontics, School of Dentistry, Chonbuk National University, Jeonju, Korea.
Institute of Oral Biosciences, School of Dentistry, Chonbuk National University, Jeonju, Korea.
Korean J Orthod. 2020 Mar;50(2):136-144. doi: 10.4041/kjod.2020.50.2.136. Epub 2020 Mar 24.
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.
半侧颜面短小畸形（HFM）患者在生长发育期可能因其面部外观异常而出现情绪退缩。早期进行牵张成骨以改善外观可鼓励这些患者。早期牵张成骨可克服患侧的一些异常情况。然而，由于HFM的特点，在剩余的生长发育期内，患侧与未患侧之间的生长速度差异是不可避免的。因此，生长完成后应进行重新评估，以便通过正颌手术或掩饰性正畸治疗实现稳定的咬合。一名8岁患者前来就诊，表现出HFM特征，下颌轻度受累。他接受了一期牵张成骨治疗和功能性矫治器治疗。在右侧升支进行牵张成骨，导致右侧后牙列出现开牙合。牵张成骨后，使用功能性矫治器和部分固定矫治器使患侧后牙列伸长，并使未患侧后牙列的咬合调整稳定。患者定期到诊所进行随访评估，20岁时，他出现下颌面部不对称，向右侧偏斜。生长发育期结束后，他接受了正畸治疗以改善后牙列的咬合。未经正颌手术，通过掩饰性正畸治疗获得了稳定的咬合和满意的面部外观。
