Revision -Dentofacial Asymmetry 2

Question 1

Dx

Answer 1

Question 2

History

Answer 2

1. face trauma
2. bone & muscle inflammatory disorders
3. continuously progressing face & dentoalveolar asymmetry
4. syndrome or craniofacial anomaly

Question 3

Clinical examination

Answer 3

1. Pain
2. Limitations
3. Noises
4. Deviations

Question 4

X-rays and Imaging

LATERAL CEPHALOMETRY

Answer 4

In lateral cephalograms vertical asymmetries can be recognized by failure of bilateral structures to superimpose .

Question 5

Hemifacial microsomia

MANAGMENT

Answer 5

1. Treatment of HM includes orthodontic and surgical management .
2. Treatment timing and methods vary according to patient’s age , degree of facial deformity , and degree of skeletal deformity .

Question 6

Hemifacial microsomia-MANAGMENT

Treatment timing and methods vary according to:

Answer 6

1. patient’s age,
2. degree of facial deformity,
3. degree of skeletal deformity, and
4. the surgical treatment strategy.

Question 7

Hemifacial microsomia-MANAGMENT

surgical management.

Answer 7

• The costochondral grafting was performed as one of the main surgical treatment procedures from 1970s to 1990s.

Since the introduction of distraction osteogenesis on craniofacial region in 1995, it replaced the grafting and has become one of the most popular surgical treatment options so far .

Question 8

MANAGEMENT OF HEMIFACIAL MICROSOMIA

(mild, with sufficient muscle mass and good mandibular mobility)

extra

Answer 8

• Orthopedics - orthodontics only
• Treatment must start early (6-8 years)

Generation of an altered muscle balance is possible and bone apposition required for establishment of symmetry can be achieved.

Question 9

MANAGEMENT

OF HEMIFACIAL MICROSOMIA

(severe, excessive tissue deficiency)

extra

Answer 9

Orthognathic surgery

Question 10

Condylar fractures

Acute management of condylar fractures in children

Aim:

Answer 10

Aims to
1. minimize the destructive influence of fracture and
2. surgery to future mandibular growth.

Question 11

Condylar fractures

Management

Answer 11

1. IMF for a few days.
2. physiotherapy
3. non-surgical condyle manipulation or open surgery
4. orthopedics - orthodontics

Question 12

TMJ ankylosis

Management of TMJ ankylosis

Answer 12

• Immediate surgical release of the joint
• Use of functional appliances for dentoalveoral influence and symmetrical function and growth

Question 13

TMJ ankylosis

Goals of surgical treatment of ankylosis

Answer 13

1. Restore range of motion and function
2. Avoid development of malocclusion
3. Prevent recurrence of ankylosis