Korean J Orthod.  2020 Sep;50(5):336-345. 10.4041/kjod.2020.50.5.336.

Treatment modalities for Korean patients with unilateral hemifacial microsomia according to Pruzansky–Kaban types and growth stages

Affiliations
  • 1Department of Orthodontics, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
  • 2Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul, Korea
  • 3Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Korea
  • 4Private Practice, Pohang, Korea
  • 5Department of Plastic and Reconstructive Surgery, College of Medicine, Seoul National University, Seoul, Korea
  • 6Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
  • 7Private Practice, Seoul, Korea

Abstract


Objective
To investigate the treatment modalities (Tx-Mods) for patients with unilateral hemifacial microsomia (UHFM) according to Pruzansky–Kaban types and growth stages.
Methods
The samples consisted of 82 Korean UHFM patients. Tx-Mods were defined as follows: Tx-Mod-1, growth observation due to mild facial asymmetry; Tx-Mod-2, unilateral functional appliance; TxMod-3, fixed orthodontic treatment; Tx-Mod-4, growth observation due to a definite need for surgical intervention; Tx-Mod-5, unilateral mandibular or bimaxillary distraction osteogenesis (DO); Tx-Mod-6, maxillary fixation using LeFort I osteotomy and mandibular DO/sagittal split ramus osteotomy; TxMod-7, orthognathic surgery; and Tx-Mod-8, costochondral grafting. The type and frequency of Tx-Mod, the number of patients who underwent surgical procedures, and the number of surgeries that each patient underwent, were investigated. Results: The degree of invasiveness and complexity of Tx-Mod increased, with an increase in treatment stage and Pruzansky–Kaban type (initial < final; [I, IIa] < [IIb, III], all p < 0.001). The percentage of patients who underwent surgical procedures increased up to 4.2 times, with an increase in the Pruzansky–Kaban type (I, 24.1%; IIa, 47.1%; IIb, 84.4%; III, 100%; p < 0.001).However, the mean number of surgical procedures that each patient underwent showed a tendency of increase according to the Pruzansky–Kaban types (I, n = 1.1; IIa, n = 1.5; IIb, n = 1.6; III, n = 2.3; p > 0.05).
Conclusions
These findings might be used as basic guidelines for successful treatment planning and prognosis prediction in UHFM patients.

Keyword

Treatment modality; Unilateral hemifacial microsomia
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