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Orthodontics IV > W6-DENTOFACIAL ASYMMETRY 1 > Flashcards

W6-DENTOFACIAL ASYMMETRY 1 Flashcards

1
Q

Minor asymmetry

Definition:

A

Minor asymmetry is a desirable variation of the craniofacial structures because these little inconsistencies are perceived as esthetically pleased.

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2
Q

What type of assymetry is perceived as significant?

A

Asymmetry of 10 mm is perceived as significant; at 5 mm and below , it is largely unnoticed .

  • The greater the degree of asymmetry, the more noticeable and the greater the desire for correction.
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3
Q

What percentage of patients with dentofacial deformities were found to have clinically apparent facial asymmetry?

A

34% of patients with dentofacial deformities were found to have clinically apparent facial asymmetry .

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4
Q

Percentage of facial assymetry according to site:

A
  1. upper face-> 5%
  2. midface (primarily nose) -> 36%
  3. chin->74%
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5
Q

Dentofacial Asymmetry

Age:

A
  • preadolescent children
  • adolescents
  • adults
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6
Q

HEMIFACIAL MICROSOMIA (CRANIOFACIAL MICROSOMIA)

Characteristics:

A
  • Involves mostly unilateral condylar underdevelopment
  • Greatly variable abnormalities of the external and middle ear
  • Similar manifestations with Goldenhar syndrome [additionally, vertebral defects and epibular dermoids ]
  • Etiology is heterogeneous
  • The extend of TMJ involvement determines timing and type of treatment
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7
Q

HEMIFACIAL MICROSOMIA (CRANIOFACIAL MICROSOMIA)

Prevalence

A
  • Congenital disease of craniofacial region
  • Occurs in 1/3500 – 1/5600 births
  • It is called as such because it occurs mainly on one side of the face as the small jaw
  • It can be also manifested at both sides of the face simultaneously in 10-15 % of patients
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8
Q

Hemifacial Microsomia

Hemifacial Microsomia results from:

A

Hemifacial Microsomia results from the malformation of the 1st and 2nd branchial arches .

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9
Q

Skeletal Defects

The main etiopathogenic units are:

A

The main etiopathogenic units are the condyle and angle in the hemifacial microsomia mandible .

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10
Q

Soft Tissue Defects

A
  1. skin tags
  2. facial clefts
  3. cranial nerve function
  4. soft palate function
  5. ear abnormalities
  6. bulk of subcutaneous soft tissue
  7. muscles of mastication and facial expression
  8. macrostomia
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11
Q

Hemifacial microsomia

Signs and symptoms:

A

Hemifacial microsomia can present variable signs and symptoms, ranging from the slight asymmetry of face to the complete absence of one ear , small ipsilateral face , facial nerve palsy , and the cleft of the mouth corner .

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12
Q

CLASSIFICATION SYSTEMS OF HEMIFACIAL MICROSOMIA

A
  • OMENS [abbreviation of 1ST letter of orbit, mandible, ear, nerve, and soft tissue].
  • It reported more recently than other systems did.
  • It addresses the 5 major manifestations of HM and allows each to be graded separately according to severity.
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13
Q

The Goldenhar syndrome is characterized by:

A

The Goldenhar syndrome is characterized by the typical features of hemifacial microsomia with the addition of epibulbar dermoids and vertebral anomalies .

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14
Q

HEMIMANDIBULAR HYPERPLASIA

Characteristics:

A
  1. uncommon maxillofacial deformity
  2. increase in ramus height
  3. rotated facial appearance
  4. kinking at the mandibular symphysis
  5. prominence of the lower border of the mandible
  6. maxillary and mandibular alveolar bone overgrowth
  7. compensatory canting of occlusal plane
  8. serious functional malocclusion
  9. diffuse enlargement of the condyle, the condylar neck, the ramus, and the body of the mandible
  10. usually begins before puberty
  11. clear hyperactivity in the condyle
  12. actively proliferating cartilage
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15
Q

CONDYLAR FRACTURES

No diagnosis of condyle fractures may lead to:

A
  1. Face asymmetries
  2. Severe malocclusion
  3. TMJ ankylosis
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16
Q

TMJ Ankylosis

A
  • Chronic Hypomobility and Growth Disorders
  • Intracapsular adhesions or ossification between the disc and temporal articular surface that attach the disc-condyle complex to the articular eminence.
17
Q

TMJ Ankylosis

Classification

A
  • Degree of limitation (partial or complete)
  • Location of the union (intracapsular vs. extracapsular)
  • Type of tissues involved (fibrous, osseous, fibro-osseous)
18
Q

TMJ Ankylosis

Principle causes:

A

TMJ ankylosis occurs relatively infrequently

Principle causes:
1. Trauma (fracture / hemarthrosis) (31–98%) »
2. Previous joint surgery
3. Systemic or local infections (10–49%)
4. Tumors
5. Systemic diseases (10%)

19
Q

TMJ Ankylosis

History

A
  • Patients report limited mouth opening without any pain .
  • The condition has been present for a long time .
  • Patient does not feel that it poses a significant problem.
20
Q

TMJ Ankylosis

Clinical characteristics

A
  1. The condyle can still rotate, with some degree of restriction on the inferior surface of the disc.
  2. Decreased opening.
  3. Lateral movements are restricted.
  4. Opening pathway deflects to the ipsilateral side.
21
Q

JUVENILE RHEUMATOID ARTHRITIS

A
22
Q

MUSCLE PATHOLOGY

A

Dermatomyositis

23
Q

TUMORS

A

Orthodontics IV (23 decks)

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