RESUMO
AIM: To study the efficacy of modified simultaneous maxillary-mandibular distraction to correct facial asymmetry in patients with compensated occlusion and a canted occlusal plane. PATIENTS AND METHODS: During the period January 1998-December 2003, 15 patients with facial asymmetry (8 male and 7 female, mean age 18 years) were treated using a modified technique of simultaneous maxillary-mandibular distraction. Their facial deformities were caused by hemicraniofacial microsomia (n=6) or ankylosis of the temporomandibular joint (TMJ) (n=9). RESULTS: The mean (range) gain in mandibular height was 16 (13-22) mm, and increase in elongation 14 (11-18) mm achieved over 11-22 days. Predicted movement on cephalometric analysis correlated closely with the actual distraction (mean accuracy 0.4mm). CONCLUSION: Simultaneous bimaxillary distraction osteogenesis is a robust technique that provides the surgeon with the ability to correct facial asymmetry in patients with hemicraniofacial microsomia and those with facial deformity after ankylosis of the TMJ. A cephalometric prediction tracing made before distraction is a reliable guide to the actual distraction needed to correct the facial deformities in these patients.
Assuntos
Assimetria Facial/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Procedimentos Cirúrgicos Ortognáticos , Osteogênese por Distração/métodos , Adolescente , Adulto , Anquilose/complicações , Cefalometria , Assimetria Facial/etiologia , Feminino , Humanos , Masculino , Microstomia/complicações , Transtornos da Articulação Temporomandibular/complicaçõesRESUMO
The records of 55 patients with ankylosis of the temporomandibular joint (25 unilateral and 30 bilateral); were selected at random. In these patients, the resected condyles had been replaced with costochondral grafts and the patients were followed clinically and radiographically for 7-10 years. Of the 85 grafts, we found take and good remodeling in 50 (59%), reankylosis in 8 (9%), resorption of the graft in 21 (25%) and overgrowth of the graft in 3 (4%). Mouth opening was satisfactory (more than 25 mm) in 32 of the 55 patients (58%), unsatisfactory (between 5 and 25 mm) in 10 (18%), and the operation was a failure in 13 (24%).
