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Treatment modalities for Korean patients with unilateral hemifacial microsomia according to Pruzansky?Kaban types and growth stages

대한치과교정학회지 2020년 50권 5호 p.336 ~ 345
양일형, 정지혁, 임선진, 조일식, 김석화, 최진영, 이종호, 김명진, 백승학,
소속 상세정보
양일형 ( Yang Il-Hyung ) - Seoul National University School of Dentistry Department of Orthodontics
정지혁 ( Chung Jee-Hyeok ) - Seoul National University Hospital Department of Plastic and Reconstructive Surgery
임선진 ( Yim Sun-Jin ) - Seoul National University School of Dentistry Department of Orthodontics
조일식 ( Cho Il-Sik ) - Private practice
김석화 ( Kim Suk-Wha ) - Seoul National University College of Medicine Department of Plastic and Reconstructive Surgery
최진영 ( Choi Jin-Young ) - Seoul National University School of Dentistry Department of Oral and Maxillofacial Surgery
이종호 ( Lee Jong-Ho ) - Seoul National University School of Dentistry Department of Oral and Maxillofacial Surgery
김명진 ( Kim Myung-Jin ) - Private practice
백승학 ( Baek Seung-Hak ) - Seoul National University School of Dentistry Department of Orthodontics

Abstract


Objective: To investigate the treatment modalities (Tx-Mods) for patients with unilateral hemifacial microsomia (UHFM) according to Pruzansky?Kaban types and growth stages.

Methods: The samples consisted of 82 Korean UHFM patients. Tx-Mods were defined as follows: Tx-Mod-1, growth observation due to mild facial asymmetry; Tx-Mod-2, unilateral functional appliance; Tx- Mod-3, fixed orthodontic treatment; Tx-Mod-4, growth observation due to a definite need for surgical intervention; Tx-Mod-5, unilateral mandibular or bimaxillary distraction osteogenesis (DO); Tx-Mod-6, maxillary fixation using LeFort I osteotomy and mandibular DO/sagittal split ramus osteotomy; Tx- Mod-7, orthognathic surgery; and Tx-Mod-8, costochondral grafting. The type and frequency of Tx-Mod, the number of patients who underwent surgical procedures, and the number of surgeries that each patient underwent, were investigated.

Results: The degree of invasiveness and complexity of Tx-Mod increased, with an increase in treatment stage and Pruzansky?Kaban type (initial < final; [I, IIa] < [IIb, III], all p < 0.001). The percentage of patients who underwent surgical procedures increased up to 4.2 times, with an increase in the Pruzansky?Kaban type (I, 24.1%; IIa, 47.1%; IIb, 84.4%; III, 100%; p < 0.001). However, the mean number of surgical procedures that each patient underwent showed a tendency of increase according to the Pruzansky?Kaban types (I, n = 1.1; IIa, n = 1.5; IIb, n = 1.6; III, n = 2.3; p > 0.05).

Conclusions: These findings might be used as basic guidelines for successful treatment planning and prognosis prediction in UHFM patients.

키워드

Treatment modality; Unilateral hemifacial microsomia

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