Facial Asymmetry in Unilateral Condylar Hyperplasia: Comparing Treatment for Active versus Burnt-Out Disease.

Autor:	Maniskas S; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine; and the Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut School of Dental Medicine., Ly CL; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine; and the Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut School of Dental Medicine., Parsaei Y; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine; and the Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut School of Dental Medicine., Bruckman KC; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine; and the Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut School of Dental Medicine., Steinbacher DM; From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine; and the Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut School of Dental Medicine.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery [Plast Reconstr Surg] 2020 Oct; Vol. 146 (4), pp. 439e-445e.
DOI:	10.1097/PRS.0000000000007154
Abstrakt:	Background: Facial asymmetry caused by unilateral condylar hyperplasia requires treatment to address facial and occlusal imbalances. There is no definitive evidence to suggest that a single intervention strategy (during either active condylar overgrowth or the burnt-out phase) results in better/more symmetric correction. This study sought to quantify preoperative and postoperative facial asymmetry in unilateral condylar hyperplasia patients comparing treatment for active versus burnt-out disease. Methods: Preoperative and postoperative three-dimensional photographs were obtained. Images were compared to those of unaffected controls as a standard for normal facial symmetry. Facial asymmetry was assessed using root-mean-square deviation. Paired t tests were performed to compare the root-mean-square deviations of preoperative and postoperative images between the unilateral condylar hyperplasia groups and against controls. Results: Forty patients were included (11 active, nine burnt-out, and 20 controls) and 60 three-dimensional images were evaluated. Preoperatively, patients in the burnt-out group had worse asymmetry than those with active unilateral condylar hyperplasia (p = 0.011). Both groups demonstrated significantly improved symmetry postoperatively (active, p = 0.0069; burnt-out, p = 1.74E-4). However, burnt-out patients remained with some residual asymmetry (p = 4.75E-4), whereas their active counterparts showed no significant difference compared to unaffected controls (p = 0.089). Conclusions: Patients with end-stage unilateral condylar hyperplasia have more severe facial asymmetry that is more difficult to normalize compared to earlier intervention during active unilateral condylar hyperplasia. These findings suggest that, if possible, corrective intervention is preferable during active unilateral condylar hyperplasia. Clinical Question/level of Evidence: Risk, II.
Databáze:	MEDLINE
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