<< Back to the abstract archive
Leveling The Maxillary Occlusal Plane Without Orthodontic Appliances In Patients With Hemifacial Microsomia Using Unilateral Vertical Mandibular Distraction Osteogenesis
Navid Pourtaheri, MD, PhD;
Anand R. Kumar, MD, FACS
Case Western Reserve University School of Medicine
2018-02-10
Presenter: Navid Pourtaheri, MD, PhD
Affidavit:
The bulk of the work submitted by Dr. Navid Pourtaheri represents his original contribution.
Director Name: Anand R. Kumar
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Purpose: Orthodontic appliances require consideration of cost and patient-compliance. We evaluated the efficacy of unilateral vertical mandibular distraction-osteogenesis (vMDO) in leveling the maxillary occlusal plane without orthodontic appliances in patients with hemifacial microsomia (HFM).
Methods: A retrospective study was performed on consecutive patients with HFM over an 18-month period who underwent unilateral vMDO by a single surgeon for correction of Kaban-Pruzansky type-II mandibular deformities. Patients with complete records and 12-months minimum clinical follow-up were included. PA cephalograms were analyzed for ramus height, maxillary height, dentoalveolar height, chin point deviation, occlusal height, and occlusal plane.
Results: Five patients met inclusion criteria, three were female, median age was 12.6 years, median distraction length was 21.3mm. Median radiographic follow-up was 6 months (range 4-38). No major or minor complications occurred during the study period. Ramus height was increased a median length of 12.0mm, corresponding to a differential (non-distracted minus distracted side) of 15.0mm preoperatively and 0.25mm at radiographic follow-up. Chin point distance from vertical midline was a median of 7.35mm preoperatively and 5.55mm at radiographic follow-up. Median maxillary height differential was 3mm preoperatively and 1.35mm at radiographic follow-up. Median maxillary occlusal height differential was 3.8mm preoperatively and 2.1mm at radiographic follow-up. The occlusal plane cant angle was decreased by a median of 84.6% (8.5-degrees preoperatively and 1.3-degrees at radiographic follow-up).
Conclusion: Unilateral vMDO improves ramus height and chin point deviation and effectively levels the maxillary occlusal plane without the need for intraoral orthodontic appliances in patients with HFM and Kaban-Pruzansky type-II mandibular deformities.
