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하악과두 골절후 발생한 편측성 하악골 형성부전의 치료로서 복합적 악골 신장술의 임상증례
오승환(Sung-Hwan Oh),민승기(Seung-Gi Min),권경환(Kyong-Hwan Kwon),고세욱(Se-Wook Koh),이경석(Kyong-Seuk Lee) 대한구강악안면외과학회 2004 대한구강악안면외과학회지 Vol.30 No.3
Uni- or bilateral mandibular hypoplasia can be associated with various syndromes or is acquired after early traumatic or inflammatory disease in the temporomandibular joint(TMJ). Early treatment is necessary to avoid consequent impairment of midfacial growth. The standard treatment of these malformations consists of the application of bone grafts which can lead to unpredictable growth, but the new procedure of bone lengthening which was presented by McCarthy et al. represents a limited surgical intervention and therefore open up a new perspective of treatment, especially in younger children with severe deformities. Patients with hemifacial microsomia and facial asymmetry have a vertically short maxilla, a tilted occlusal plane, and a short mandible. A 14-years-old boy with facial asymmetry, who was fractured on both condyle and mandibular symphysis before 8 years ago, was treated by mandibular ramus lengthening, symphysial widening and surgically assisted rapid palatal expansion with corticotomy. After allowing 1 week for the healing of the periosteum, the distraction was performed at the rate of 0.5-1.0mm per day for 7 days on maxilla and 14 days on mandible. The device was maintained on maxilla and mandible for 12 weeks following distraction. The difference in ramus and mandibular transverse deficiency were corrected and facial asymmetry was improved with complex distraction osteogenesis.
ScienceON
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