The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Treatment modalities for Korean patients with unilateral hemifacial microsomia according to Pruzansky-Kaban types and growth stages

  • Yang, Il-Hyung (Department of Orthodontics, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Chung, Jee Hyeok (Department of Plastic and Reconstructive Surgery, Seoul National University Hospital) ;
  • Yim, Sunjin (Department of Orthodontics, School of Dentistry, Seoul National University) ;
  • Cho, Il-Sik (Private Practice) ;
  • Kim, Sukwha (Department of Plastic and Reconstructive Surgery, College of Medicine, Seoul National University) ;
  • Choi, Jin-Young (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Lee, Jong-Ho (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Kim, Myung-Jin (Private Practice) ;
  • Baek, Seung-Hak (Department of Orthodontics, Dental Research Institute, School of Dentistry, Seoul National University)
  • Received : 2020.03.17
  • Accepted : 2020.06.10
  • Published : 2020.09.30
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Abstract

Objective: To investigate the treatment modalities (Tx-Mods) for patients with unilateral hemifacial microsomia (UHFM) according to Pruzansky-Kaban types and growth stages. Methods: The samples consisted of 82 Korean UHFM patients. Tx-Mods were defined as follows: Tx-Mod-1, growth observation due to mild facial asymmetry; Tx-Mod-2, unilateral functional appliance; Tx-Mod-3, fixed orthodontic treatment; Tx-Mod-4, growth observation due to a definite need for surgical intervention; Tx-Mod-5, unilateral mandibular or bimaxillary distraction osteogenesis (DO); Tx-Mod-6, maxillary fixation using LeFort I osteotomy and mandibular DO/sagittal split ramus osteotomy; Tx-Mod-7, orthognathic surgery; and Tx-Mod-8, costochondral grafting. The type and frequency of Tx-Mod, the number of patients who underwent surgical procedures, and the number of surgeries that each patient underwent, were investigated. Results: The degree of invasiveness and complexity of Tx-Mod increased, with an increase in treatment stage and Pruzansky-Kaban type (initial < final; [I, IIa] < [IIb, III], all p < 0.001). The percentage of patients who underwent surgical procedures increased up to 4.2 times, with an increase in the Pruzansky-Kaban type (I, 24.1%; IIa, 47.1%; IIb, 84.4%; III, 100%; p < 0.001). However, the mean number of surgical procedures that each patient underwent showed a tendency of increase according to the Pruzansky-Kaban types (I, n = 1.1; IIa, n = 1.5; IIb, n = 1.6; III, n = 2.3; p > 0.05). Conclusions: These findings might be used as basic guidelines for successful treatment planning and prognosis prediction in UHFM patients.

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