W7-DENTOFACIAL ASYMMETRY 2

Question 1

DIAGNOSIS

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

LATERAL CEPHALOMETRY

Answer 4

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

Question 5

Hemifacial microsomia

Answer 5

• Treatment timing and methods vary according to patient’s age , degree of facial deformity , and degree of skeletal deformity .
• Treatment of HM includes orthodontic and surgical management .
• 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 6

MANAGEMENT
OF HEMIFACIAL MICROSOMIA
(mild, with sufficient muscle mass and good mandibular mobility)

Answer 6

• 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 7

MANAGEMENT
OF HEMIFACIAL MICROSOMIA (severe, excessive tissue deficiency)

Answer 7

Orthognathic surgery

Question 8

Condylar fractures

Answer 8

Acute management of condylar fractures in children

Question 9

Condylar fractures

Aim

Answer 9

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

Question 10

Condylar fractures

Management

Answer 10

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

Question 11

TMJ ankylosis

Management of TMJ ankylosis

Answer 11

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

Question 12

TMJ ankylosis

Goals of surgical treatment of ankylosis

Answer 12

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