title: Ten-year follow-up of a patient with hemifacial microsomia treated with distraction osteogenesis and orthodontics: an implant analysis.
abstract: BACKGROUND
  Distraction osteogenesis (DO) has become an accepted treatment method for patients requiring mandibular lengthening because of congenital malformations. However, the skeletal growth pattern of a distracted mandible in the long term has still not been clearly shown in the literature. The purpose of this report was to analyze the dentofacial changes observed during a 10-year follow-up period in a patient treated with mandibular DO.
  
  
  METHODS
  The patient was a 12-year-old girl with hemifacial microsomia who had undergone DO with an external device. Morphologic changes during the observation period were evaluated on panoramic radiographs and posteroanterior and lateral cephalograms. Six Björk-type titanium implants were placed bilaterally in the mandible under local anesthesia to analyze the mandibular skeletal changes over time.
  
  
  RESULTS
  Marked lengthening was achieved during the active phase of mandibular distraction. The ratio between the ramus heights of the affected and normal sides improved significantly in the affected side's favor as the mandible was lengthened, but this ratio returned to its initial value after 10 years.
  
  
  CONCLUSIONS
  Although there was some growth on the affected side during the follow-up period, it was not enough to catch up with the growth on the normal side. The original asymmetry recurred as a consequence of the growth pattern in this patient with hemifacial microsomia.
authors.affiliation: Department of Orthodontics, School of Dentistry, University of Ankara, Ankara, Turkey. iseri@dentistry.ankara.edu.tr
authors.forename: Haluk
authors.initials: H
authors.lastname: Işeri
authors.forename: Reha
authors.initials: R
authors.lastname: Kişnişci
authors.forename: Ayşe T
authors.initials: AT
authors.lastname: Altuğ-Ataç
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002508:Cephalometry / Q000379:methods*; D002648:Child; D015921:Dental Implants; D005146:Facial Asymmetry / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008334:Mandible / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000254:growth & development; D019186:Mandibular Advancement / Q000379:methods*; D009971:Orthodontics, Corrective / Q000379:methods; D019857:Osteogenesis, Distraction / Q000379:methods*; D011859:Radiography; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants