title: Team management and treatment outcomes for patients with hemifacial microsomia.
abstract: BACKGROUND
  Hemifacial microsomia is the most common congenital craniofacial anomaly after cleft lip and palate. The purpose of this study was to evaluate the final outcome of team care for patients with hemifacial microsomia after a protocol of growth management, orthodontic treatment, orthognathic surgery, and soft-tissue augmentation.
  
  
  METHODS
  This was a retrospective study with chart reviews, radiographs, and photographs to document the treatment interventions and outcomes. Six patients, 2 in each of 3 mandibular types, who had recently completed treatment and had complete records available and were not previously reported, were included. Facial midlines and maxillary and mandibular deviations from the midline were measured.
  
  
  RESULTS
  The maxillary deviation changed by 10.0 ± 4.6 mm to a deviation from the midline of 1.1 ± 0.6 mm. The chin deviation improved by 8.1 ± 2.7 mm to a mean distance of 0.6 ± 0.5 mm from the midline. The occlusal plane can't changed from 7.0° ± 4.2° to 2.3° ± 1.4°. All changes were significant.
  
  
  CONCLUSIONS
  Facial asymmetry in patients with hemifacial microsomia can be significantly improved by stepwise orthodontic treatment, orthognathic and facial surgery, and soft-tissue augmentation. As for most craniofacial conditions, team care is essential.
authors.affiliation: Department of Orthodontics and Craniofacial Developmental Biology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Ohtani
authors.forename: William Y
authors.initials: WY
authors.lastname: Hoffman
authors.forename: Karin
authors.initials: K
authors.lastname: Vargervik
authors.forename: Snehlata
authors.initials: S
authors.lastname: Oberoi
mesh_terms: D000293:Adolescent; D002508:Cephalometry / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D002680:Chin / Q000601:surgery; D002985:Clinical Protocols; D054893:Cone-Beam Computed Tomography; D005146:Facial Asymmetry / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008310:Malocclusion / Q000209:etiology / Q000601:surgery / Q000628:therapy; D008334:Mandible / Q000002:abnormalities / Q000601:surgery; D008437:Maxilla / Q000002:abnormalities / Q000601:surgery; D009971:Orthodontics, Corrective / Q000379:methods; D056948:Orthognathic Surgical Procedures; D019340:Osteotomy, Le Fort; D059229:Osteotomy, Sagittal Split Ramus; D010348:Patient Care Team; D023861:Photography, Dental; D019651:Plastic Surgery Procedures; D063173:Retrognathia / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome