Restitution of the Temporomandibular Joint in Patients with Craniofacial Microsomia After Multiplanar Mandibular Distraction: Assessment by Magnetic Resonance Imaging

Morphologic Changes of the Temporomandibular Joint in Pruzansky-Kaban Type IIa Hemifacial Microsomia Postmandibular Distraction Osteogenesis

“…In addition, magnetic resonance imaging scans revealed functional displacements of the rudimentary condyledisk complex and increased signal intensity radio-density of the pseudodisk fibrous tissue post-MDO, thus demonstrating that distraction histogenesis attained physiological equilibrium within the complex adaptive (TMJ) system. 26 We found that the height of the coronoid process, the distance between the condyle and the coronoid process, and the angle of the mandibular notch, remained unchanged post-MDO. Although the height of the affected condyle shortened post-MDO, the length of the affected mandibular ramus and the distance between the affected condyle and the affected menton lengthened post-MDO.…”

“…In another study, Master et al8 found that during the distraction period, a patient could posture the jaw forwards; this could be the result of pain or swelling in the joints. In addition, magnetic resonance imaging scans revealed functional displacements of the rudimentary condyle-disk complex and increased signal intensity radio-density of the pseudodisk fibrous tissue post-MDO, thus demonstrating that distraction histogenesis attained physiological equilibrium within the complex adaptive (TMJ) system 26…”

Management of An Asymmetric Class ii Malocclusion In Association With Mandibular Deformity. A Case Report Y.

“…A modified surgical procedure involving mandibular osteotomy in the midline to correct transverse discrepancy problems was presented by Anghinoni et al [26] Recent studies also advocate the use of multiplanar distraction osteogenesis in correction of facial asymmetry especially caused by mandibular hypoplasia. [27][28][29] In cases of hemifacial microsomia, it has been proved to improve facial asymmetry by lengthening of the mandibular ramus and concomitant increased volume of the soft tissues by adjusting the volume of the medial pterygoid . [30] Thus, proper diagnosis and subsequent treatment of the facial and dental asymmetry ensures appropriate and stable treatment.…”

Reader’s Forum

“…For example, the authors did not mention the coronoid process and the angle of the mandible in their narrative, both of which are dependent on muscle development. On the other hand, they also omitted the epigenetic potential of condylar stem cells 2 and cranial base orthocephalization, 3 both of which play significant roles in determining clinical mandibular morphology and spatial orientation. In effect, the ramus width might simply be a by-product of other proactive developmental processes; perhaps the developmental ontogeny of the mandible described in this article is based on, some might say, outdated concepts.…”