title: Occlusal difficulties after simultaneous mandibular and maxillary distraction in an adult case of hemifacial microsomia.
abstract: A 23-year-old woman with hemifacial microsomia type IIB was treated by simultaneous mandibular and maxillary distraction. During the course of the distraction, cephalometric analysis showed that the maxilla was not moving downward and that the upper edge of the mandibular condyle was moving upward into the space between the condyle and the glenoid fossa. This phenomenon could lead to early consolidation of the osteotomized maxilla, resulting in malposition and occlusal difficulties. This is thought to be a problem unique to bimaxillary distraction of hemifacial microsomia type IIB with severe hypoplasia of the mandibular ramus and space between the condyle and the glenoid fossa. Surgeons should be alerted to this risk and prepared to address it when performing this procedure.
authors.affiliation: Department of Plastic and Reconstructive Surgery, University of Tokushima School of Medicine, 2-50-1 Kuramoto-cho, Tokushima 770-8503, Japan. kazuya@clin.med.tokushima-u.ac.jp
authors.forename: Kazuya
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakanishi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Koizumi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamano
authors.forename: Ichiro
authors.initials: I
authors.lastname: Hashimoto
authors.forename: Shuta
authors.initials: S
authors.lastname: Satake
authors.forename: Keiji
authors.initials: K
authors.lastname: Moriyama
mesh_terms: D000328:Adult; D016025:Bone Transplantation; D002508:Cephalometry; D005146:Facial Asymmetry / Q000145:classification / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008310:Malocclusion / Q000209:etiology*; D008334:Mandible / Q000601:surgery*; D008335:Mandibular Condyle / Q000473:pathology; D008437:Maxilla / Q000601:surgery*; D019857:Osteogenesis, Distraction / Q000009:adverse effects / Q000379:methods; D010027:Osteotomy / Q000379:methods; D019340:Osteotomy, Le Fort / Q000379:methods; D013701:Temporal Bone / Q000473:pathology