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      Corrección de microsomía hemifacial con prótesis de articulación temporomandibular con extensión a arco cigomático y cirugía ortognática Translated title: Hemifacial microsomy correction with temporomandibular joint prosthesis with zygomatic arch extension and orthognathic surgery

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          Abstract

          RESUMEN La planificación cuidadosa del tratamiento quirúrgico es fundamental para corregir la asimetría facial en pacientes con microsomía hemifacial, que conduzca a un resultado favorable en estabilidad funcional y estético. En el presente artículo se reporta un caso clínico de microsomía hemifacial en paciente femenina de 28 años de edad con cirugía ortognática previa, la cual no cumplió los objetivos estéticos y funcionales. Con planificación virtual se realiza el diseño de una prótesis de articulación temporomandibular que incluye la reconstrucción del arco cigomático hasta la región mastoidea concomitante con cirugía ortognática, logrando una armonía facial y estabilidad esquelética a largo plazo.

          Translated abstract

          ABSTRACT The careful planning of surgical treatment is essential to correct facial asymmetry in patients with hemifacial microsomia, leading to a favorable result in functional and aesthetic stability. In the present article reports a clinical case of hemifacial microsomia in a 28-year-old female patient with previous orthognathic surgery, which did not meet the aesthetic and functional objectives. With virtual planning, the design of a temporomandibular joint prosthesis is carried out that includes the reconstruction of the zygomatic arch up to the mastoid region concomitant with orthognathic surgery, achieving facial harmony and long-term skeletal stability.

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          Surgical Correction of Hemifacial Microsomia in the Growing Child

          This is a follow-up study of 20 children who had surgical correction of hemifacial microsomia in an effort to improve facial growth and minimize secondary distortion. In group 1 (skeletal types I and IIA), 10 children underwent elongation and lengthening of the mandible. In group 2 (skeletal types IIB and III), 10 children had total construction of a new temporomandibular joint and mandibular ramus with rib grafts and costochondral junction. In both groups, an open bite was created on the affected side to provide space for tooth eruption and downward growth of the middle face. The mean follow-up was 50.9 months (18 to 117 months) in group 1 and 45 months (18 to 50 months) in group 2. Analysis of our early results showed that all patients have had downward growth of the midface on the affected side. All five patients in group 1, followed to complete closure of the surgically created open bite, have maintained a level occlusal plane. In group 2, the one patient followed to completion of facial growth continues to have a level occlusal plane and facial symmetry. Appropriately timed mandibular construction and/or elongation in children with hemifacial microsomia is safe and effective. There is a decrease in secondary deformity on the affected side, and the eventual overall facial growth is optimized. Some group 2 children will need secondary elongation and augmentation of the mandible. Nevertheless, this study demonstrates that early mandibular correction may obviate the need for maxillary and orbital procedures in adulthood.
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            Surgical Management of Congenital Deformities with Temporomandibular Joint Malformation

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              Successful reconstruction of nongrowing hemifacial microsomia patients with unilateral temporomandibular joint total joint prosthesis and orthognathic surgery.

              Traditionally, patients with hemifacial microsomia (HFM) and significant ipsilateral hypoplasia or absence of the condyle and ramus undergo reconstruction on the ipsilateral side with autogenous tissues such as rib grafts, often with compromised results. This study analyzed the surgical treatment outcomes of nongrowing patients with HFM and reconstruction of the ipsilateral temporomandibular joint (TMJ) and advancement of the mandible with a patient-fitted TMJ total joint prosthesis (TMJ Concepts, Inc, Ventura, CA), a contralateral mandibular ramus sagittal split osteotomy, and maxillary osteotomies performed in 1 operation.
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                Author and article information

                Journal
                maxi
                Revista Española de Cirugía Oral y Maxilofacial
                Rev Esp Cirug Oral y Maxilofac
                Sociedad Española de Cirugía Oral y Maxilofacial y de Cabeza y Cuello (Madrid, Madrid, Spain )
                1130-0558
                2173-9161
                December 2021
                : 43
                : 4
                : 156-161
                Affiliations
                [1] Bogotá DC orgnameHospital Militar Central orgdiv1Servicio de Cirugía Oral y Maxilofacial Colombia
                Article
                S1130-05582021000400006 S1130-0558(21)04300400006
                10.20986/recom.2021.1303/2021
                80f9c82f-6740-46f8-8c8f-21a984d24755

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 30 July 2021
                : 18 November 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 11, Pages: 6
                Product

                SciELO Spain

                Categories
                Casos Clínicos

                asimetría de tejidos duros y blandos,simulación quirúrgica 3D,Temporomandibular joint,orthognatic surgery,hemifacial microsomia,Skeletal and soft tissue asymmetry,3D surgical simulation,Articulación temporomandibular,cirugía ortognática,microsomía hemifacial

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