title: Functional improvements after orthodontic-surgical reconstruction in a patient with multiple maxillofacial fractures.
abstract: Patients with multiple craniofacial fractures often suffer from stomatognathic problems after their primary treatment, because administering emergency care is the clinician's highest priority. Therefore, optimal bone repositioning is sometimes difficult because bone fixation is delayed. Moreover, neither an adequate radiographic examination nor an evaluation of primary occlusion is available during the repair of fractured bones. The lack of these assessments can also lead to occlusal dysfunction after bone fixation. As a result, patients with craniofacial fractures often require occlusal reconstruction. This report describes the successful occlusal reconstruction with orthodontic-surgical treatment of a patient with multiple maxillofacial bone fractures. Combined surgery, including an intraoral vertical ramus osteotomy and a mandibular body osteotomy, was performed to reposition the deviated mandible after 3 months of preoperative orthodontic treatment. The total active treatment period was 25 months. After treatment, both the facial asymmetry and the anterior open bite caused by the skeletal disharmony were significantly improved. Additionally, the range of condylar motion, maximum occlusal force, and occlusal contact area during maximum clenching were also increased. These stomatognathic functions were further enhanced by 2 years of retention. Orthodontic-surgical reconstruction appears to improve both facial esthetics and occlusal function in patients with facial asymmetry caused by severe traumatic maxillofacial fractures.
authors.affiliation: Department of Orthodontics, Graduate School of Medicine and Dentistry, Okayama University, Japan. ishihara@md.okayama-u.ac.jp
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Ishihara
authors.forename: Shingo
authors.initials: S
authors.lastname: Kuroda
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Nishiyama
authors.forename: Akira
authors.initials: A
authors.lastname: Sasaki
authors.forename: Teruko
authors.initials: T
authors.lastname: Takano-Yamamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamashiro
mesh_terms: D000328:Adult; D001732:Bite Force; D003766:Dental Occlusion; D005146:Facial Asymmetry / Q000601:surgery / Q000628:therapy; D005147:Facial Bones / Q000293:injuries*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008313:Malocclusion, Angle Class III / Q000601:surgery / Q000628:therapy; D008335:Mandibular Condyle / Q000293:injuries / Q000503:physiopathology; D063168:Mandibular Osteotomy / Q000379:methods; D009119:Muscle Contraction / Q000502:physiology; D024343:Open Bite / Q000601:surgery / Q000628:therapy; D009971:Orthodontics, Corrective / Q000379:methods*; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D010347:Patient Care Planning; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012887:Skull Fractures / Q000601:surgery / Q000628:therapy*