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Aiyar A, Pedersen TK, Resnick CM, Nørholt SE, Verna C, Stoustrup PB. Management of unilateral craniofacial microsomia with orthopaedic functional appliances: A systematic literature review. Orthod Craniofac Res 2024; 27 Suppl 1:131-140. [PMID: 37987216 DOI: 10.1111/ocr.12729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 11/22/2023]
Abstract
The study aimed to summarize current knowledge regarding the use of orthopaedic functional appliances (OFA) in managing unilateral craniofacial microsomia (UCM). The eligibility criteria for the review were (1) assessing use of OFA as a stand-alone treatment and (2) using OFA in combination during or after MDO. The PICO (population, intervention, comparison and outcome) format formulated clinical questions with defined inclusion and exclusion criteria. No limitations concerning language and publication year were applied. Information sources: A literature search of Medline, Scopus, Embase, Cochrane Central Register of Controlled Trials, Web of Science databases without restrictions up to 30 September 2022. The risk of bias was assessed. According to Cochrane and PRISMA guidelines, two independent authors conducted data extraction. The level of evidence for included articles was evaluated based on the Oxford evidence-based medicine database. Due to the heterogeneity of studies and insufficient data for statistical pooling, meta-analysis was not feasible. Therefore, the results were synthesized narratively. A total of 437 articles were retrieved. Of these, nine met inclusion criteria: five assessing OFA and four assessing OFA during or after MDO. There is limited evidence to suggest that stand-alone and combination treatment with OFA is beneficial for treating mild-to-moderate UCM-related dentofacial deformities in short term. No studies assessed the burden of care. In the management of UCM, there is insufficient evidence supporting the efficacy of OFA as a stand-alone treatment or when combined with MDO. Additionally, there is a lack of evidence regarding treatment protocols and the effect on the condyles and the TMJ. The study was registered at Prospero database number CRD42020204969.
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Affiliation(s)
- Akila Aiyar
- Section for Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Thomas Klit Pedersen
- Section for Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Cory M Resnick
- Harvard School of Dental Medicine and Harvard Medical School, Boston, Massachusetts, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Sven Erik Nørholt
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
- Section of Oral and Maxillofacial Surgery and Oral Pathology, Department of Dentistry and Oral Health, Aarhus Univerisity, Aarhus, Denmark
| | - Carlalberta Verna
- Department of Paediatric Oral Heath and Orthodontics, University Centre for Dental Medicine UZB University of Basel, Basel, Switzerland
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Bertin H, Merlet FL, Khonsari RH, Delaire J, Corre P, Mercier J. Dental and maxillofacial features of condylo-mandibular dysplasia: A case series of 21 patients. J Craniomaxillofac Surg 2020; 48:956-961. [DOI: 10.1016/j.jcms.2020.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 05/11/2020] [Accepted: 07/19/2020] [Indexed: 10/23/2022] Open
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Elsten EECM, Caron CJJM, Dunaway DJ, Padwa BL, Forrest C, Koudstaal MJ. Dental anomalies in craniofacial microsomia: A systematic review. Orthod Craniofac Res 2019; 23:16-26. [PMID: 31608577 PMCID: PMC7003932 DOI: 10.1111/ocr.12351] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 10/08/2019] [Accepted: 10/08/2019] [Indexed: 12/12/2022]
Abstract
Objective: To provide an overview on the prevalence and types of dental anomalies in patients with craniofacial microsomia (CFM). Eligibility criteria: Inclusion criteria were CFM and dental anomalies. The following data were extracted: number of patients, methodology, mean age, sex, affected side, severity of mandibular hypoplasia, dentition stage and dental anomalies. Information sources: Cochrane, EMBASE, PubMed, MEDLINE Ovid, Web of Science, CINAHL EBSCOhost and Google Scholar, searched until the 30 August 2019. Risk of bias: The quality was examined with the OCEBM Levels of Evidence. Included studies: In total, 13 papers were included: four retrospective cohort studies, four prospective cohort studies, four case‐control studies and one case series. Synthesis of results: The studies reported information on dental agenesis, delayed dental development, tooth size anomalies, tooth morphology and other dental anomalies. Description of the effect: Dental anomalies are more often diagnosed in patients with CFM than in healthy controls and occur more often on the affected than on the non‐affected side. Strengths and limitations of evidence: This is the first systematic review study on dental anomalies in CFM. However, most articles were of low quality. Interpretation: Dental anomalies are common in CFM, which might be linked to the development of CFM. The pathophysiology of CFM is not entirely clear, and further research is needed.
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Affiliation(s)
- Eline E C M Elsten
- Department of Oral and Maxillofacial Surgery, The Dutch Craniofacial Centre, Erasmus University Medical Center, Sophia's Children's Hospital Rotterdam, Rotterdam, The Netherlands
| | - Cornelia J J M Caron
- Department of Oral and Maxillofacial Surgery, The Dutch Craniofacial Centre, Erasmus University Medical Center, Sophia's Children's Hospital Rotterdam, Rotterdam, The Netherlands
| | - David J Dunaway
- The Craniofacial Unit, Great Ormond Street Hospital, London, UK
| | - Bonnie L Padwa
- The Craniofacial Centre, Boston Children's Hospital, Boston, MA, USA
| | - Chris Forrest
- The Center for Craniofacial Care and Research, SickKids Hospital, Toronto, Ontario, Canada
| | - Maarten J Koudstaal
- Department of Oral and Maxillofacial Surgery, The Dutch Craniofacial Centre, Erasmus University Medical Center, Sophia's Children's Hospital Rotterdam, Rotterdam, The Netherlands.,The Craniofacial Unit, Great Ormond Street Hospital, London, UK.,The Craniofacial Centre, Boston Children's Hospital, Boston, MA, USA
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Shah R, Sharif MO, Gill DS. Mind the gap: A novel technique for space closure - a case report. J Orthod 2019; 46:56-62. [PMID: 31056076 DOI: 10.1177/1465312518820328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patients presenting with severe hypodontia can be challenging to manage. They often present with significant spaces within the dental arches and the lack of permanent teeth can make anchorage control difficult. This case report demonstrates a novel technique for diastema closure in a 14-year-old with severe hypodontia. The technique allows maintenance of root parallelism during space closure in cases with reduced anchorage support. The treatment plan was agreed on a multidisciplinary hypodontia clinic and involved an upper sectional fixed orthodontic appliance to close a 7-mm midline diastema aiding subsequent partial denture provision. Treatment commenced by bonding upper primary canines and central incisors. However, attempting space closure on a 0.019 × 0.025-inch stainless-steel working archwire resulted in tipping of the incisor crowns. Two brackets were therefore placed on the labial surface of each central incisor (one incisal and one gingival). Subsequently two stainless steel working archwires and elastomeric chain were used for diastema closure. This four-bracket system provided superior control allowing space closure by bodily tooth movement. Excellent root parallelism was achieved with this innovative technique.
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Affiliation(s)
- Rupal Shah
- 1 Department of Orthodontics, Eastman Dental Hospital, London, UK
| | - Mohammad O Sharif
- 2 Department of Orthodontics, UCL Eastman Dental Institute, London, UK
| | - Daljit S Gill
- 1 Department of Orthodontics, Eastman Dental Hospital, London, UK
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Bartzela TN, Carels C, Maltha JC. Update on 13 Syndromes Affecting Craniofacial and Dental Structures. Front Physiol 2017; 8:1038. [PMID: 29311971 PMCID: PMC5735950 DOI: 10.3389/fphys.2017.01038] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 11/29/2017] [Indexed: 12/12/2022] Open
Abstract
Care of individuals with syndromes affecting craniofacial and dental structures are mostly treated by an interdisciplinary team from early childhood on. In addition to medical and dental specialists that have a vivid interest in these syndromes and for whom these syndromes are of evident interest, experts of scientific background-like molecular and developmental geneticists, but also computational biologists and bioinformaticians-, become more frequently involved in the refined diagnostic and etiological processes of these patients. Early diagnosis is often crucial for the effective treatment of functional and developmental aspects. However, not all syndromes can be clinically identified early, especially in cases of absence of known family history. Moreover, the treatment of these patients is often complicated because of insufficient medical knowledge, and because of the dental and craniofacial developmental variations. The role of the team is crucial for the prevention, proper function, and craniofacial development which is often combined with orthognathic surgery. Although the existing literature does not provide considerable insight into this topic, this descriptive review aims to provide tools for the interdisciplinary team by giving an update on the genetics and general features, and the oral and craniofacial manifestations for early diagnosis. Clinical phenotyping together with genetic data and pathway information will ultimately pave the way for preventive strategies and therapeutic options in the future. This will improve the prognosis for better functional and aesthetic outcome for these patients and lead to a better quality of life, not only for the patients themselves but also for their families. The aim of this review is to promote interdisciplinary interaction and mutual understanding among all specialists involved in the diagnosis and therapeutic guidance of patients with these syndromal conditions in order to provide optimal personalized care in an integrated approach.
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Affiliation(s)
- Theodosia N Bartzela
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité-Universitätsmedizin, Berlin, Germany.,Department of Orthodontics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Carine Carels
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - Jaap C Maltha
- Department of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, Netherlands
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Xu S, Zhang Z, Tang X, Yin L, Liu W, Shi L. The Influence of Gender and Laterality on the Incidence of Hemifacial Microsomia. J Craniofac Surg 2015; 26:384-7. [DOI: 10.1097/scs.0000000000001336] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ahiko N, Baba Y, Tsuji M, Suzuki S, Kaneko T, Kindaichi J, Moriyama K. Investigation of maxillofacial morphology and dental development in hemifacial microsomia. Cleft Palate Craniofac J 2014; 52:203-9. [PMID: 24617329 DOI: 10.1597/13-179] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective : Hemifacial microsomia (HFM) is a congenital anomaly characterized by unilateral underdevelopment of the mandible and ear. This study was conducted to characterize maxillofacial morphology and dental development in Japanese patients with HFM. Design : This is a retrospective hospital-based study. Patients : The subject population comprised 12 boys and 12 girls (average age, 9.3 years) diagnosed with HFM. Main Outcome Measures : We used posteroanterior (PA) and lateral cephalograms obtained at the first visit to analyze maxillofacial morphology and orthopantomograms to compare dental development between the affected and unaffected sides. Dental development was graded according to Nolla's stages of tooth calcification. Results : PA cephalogram analysis showed that the occlusal plane inclined upward on the affected side in each patient. The mandibular body and ramus were smaller on the affected side than on the unaffected side. Lateral cephalogram analysis showed that the patients tended to have steep mandibles, large gonial angles, and a slightly convex facial structure. The affected side/unaffected side ratio of the mandibular body and ramus correlated with SNB, ANB, convexity, and mandibular plane. The difference in dental development between the affected and unaffected sides was significant at the mandibular molars and the mandibular canine. Conclusions : This study demonstrates a correlation between lateral and frontal measurement parameters in patients with HFM. The data also showed delayed calcification in the mandibular molars on the affected side.
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Utreja A, Zahid SN, Gupta R. Solitary median maxillary central incisor in association with hemifacial microsomia: A rare case report and review of literature. Contemp Clin Dent 2011; 2:385-9. [PMID: 22346174 PMCID: PMC3276874 DOI: 10.4103/0976-237x.91810] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Solitary median maxillary central incisor (SMMCI) is a rare dental anomaly. It is estimated to occur in 1:50,000 live births. The SMMCI tooth differs from the normal central incisor in that the crown form is symmetric and it develops and erupts precisely in the midline of the maxillary dental arch in both primary and permanent dentitions. Presence of SMMCI with hemifacial microsomia (HFM) is a very rare clinical condition. We report a case of HFM in a male of Indian origin who presented with SMMCI in both primary and permanent dentitions. The association of HFM with SMMCI may be due to defective development of neural crest cells and/or lack of space in maxilla.
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Affiliation(s)
- Ashok Utreja
- Unit of Orthodontics, Oral Health Sciences Centre, PGIMER, Chandigarh, India
| | - Syed Naved Zahid
- Unit of Orthodontics, Oral Health Sciences Centre, PGIMER, Chandigarh, India
| | - Richa Gupta
- Unit of Orthodontics, Oral Health Sciences Centre, PGIMER, Chandigarh, India
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Ongkosuwito EM, de Gijt P, Wattel E, Carels CEL, Kuijpers-Jagtman AM. Dental development in hemifacial microsomia. J Dent Res 2010; 89:1368-72. [PMID: 20739700 DOI: 10.1177/0022034510378425] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Hemifacial microsomia (HFM) is a congenital disorder marked by facial asymmetry. Whether facial asymmetry accounts for asymmetrical dental development is unknown. There are few data on dental development relative to mandibular development or severity of HFM, or on development over time. We hypothesized that when mandibular development was severely disturbed, local dental development was also affected. We compared dental development scores between affected and non-affected mandibular sides in patients with HFM (n = 84) and compared these data with those collected from Dutch control children (n = 451). Logistic functions were constructed for dental age over time for all four Pruzansky/Kaban types. The results showed a tendency toward delayed dental development in Pruzansky/Kaban types IIb and III at younger ages. The temporary delay of tooth formation in patients with severe forms of HFM and the distribution of agenic teeth suggest an interaction between mandibular and dental development.
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Affiliation(s)
- E M Ongkosuwito
- Department of Orthodontics, Cleft Palate Team and Craniofacial Team, Erasmus MC-Sophia, University Medical Center, Room Sp 1408, Dr Molewaterplein 60, 3015 GJ Rotterdam, the Netherlands.
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Accelerated Development of the First and Second Mandibular Molars After Distraction Osteogenesis of the Mandible in Patients With Hemifacial Microsomia. J Craniofac Surg 2009; 20:797-800. [DOI: 10.1097/scs.0b013e3181843455] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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