Unilateral mandibular hypoplasia in adult patients: distraction osteogenesis and conventional osteotomies in a standardized sequence

J Craniofac Surg. 2014 Nov;25(6):1959-66. doi: 10.1097/SCS.0000000000000975.

Abstract

Introduction: This study analyzed the outcomes of nongrowing patients with unilateral mandibular hypoplasia treated according to a specific protocol, which combines distraction osteogenesis, orthodontic treatment, and conventional osteotomies.

Materials and methods: The patients treated were objectively evaluated. Patient's satisfaction was assessed by questionnaire. Surgical changes were analyzed using cephalometry and three-dimensional facial surface data before surgery (T0) and at long-term (T1) follow-up.

Results: Four patients were included in this study. The normalization of facial proportion and a high increase in symmetry were evident. Residual defects were documented in the postoperative symmetry of the chin. In the questionnaire, all patients gave favorable responses to their facial changes; for most of the objective parameters, all patients improved.

Conclusions: A multistage treatment protocol for the correction of facial deformities in patients with unilateral mandibular hypoplasia is a valid procedure for skeletal and occlusal stability. An evident improvement of the facial appearance is also achieved.

MeSH terms

  • Adolescent
  • Adult
  • Cephalometry / methods
  • Clinical Protocols
  • Facial Asymmetry / surgery
  • Female
  • Follow-Up Studies
  • Genioplasty / methods
  • Humans
  • Imaging, Three-Dimensional / methods
  • Longitudinal Studies
  • Male
  • Malocclusion / surgery
  • Mandible / abnormalities*
  • Mandible / surgery
  • Orthodontics, Corrective
  • Orthognathic Surgical Procedures / methods
  • Osteogenesis, Distraction / methods*
  • Osteotomy / methods*
  • Patient Satisfaction
  • Prospective Studies
  • Retrognathia / surgery
  • Rhinoplasty / methods
  • Surgery, Computer-Assisted / methods
  • Treatment Outcome
  • Young Adult