抄録
Hemifacial microsomia (HFM) is characterized by unilateral underdevelopment of facial bones and soft tissues originating from the first and second branchial arches. In this article, we report an adolescent HFM patient treated with a functional appliance to facilitate mandibular growth.
The patient was a 7-year 1-month-old boy with the chief complaint of open bite and facial asymmetry. He had Pruzansky Grade II deformity of the mandible. The overjet was 7.0 mm, the overbite was -5.0 mm, and Hellman's dental age was IIC. The left lower second premolar was congenitally missing and the left lower first molar showed a 90-degree mesio-buccal rotation. The postero-anterior cephalometric analysis revealed that the mandible was shifted to the left side and the occlusal plane was tilted upward on the left side. The lateral cephalometric analysis showed a small and distally-located mandible with clockwise rotation. Prior to orthognathic treatment started at 15 years old, the first phase of treatment was initiated with a functional appliance and headgear for a period of 1 year and 10 months at 12 years 10 months old.
During the initial 4 years of treatment from the first consultation at 7 years 1 month old, the amount of occlusal plane inclination and lateral shift of the mandible increased due to a lack of patient cooperation. Nevertheless, use of the functional appliance improved the facial asymmetry due to lateral shift of the mandible. On the lateral cephalogram, a remarkable mandibular growth was found on the asymptomatic left side of the mandible.
