Roentgen stereometry with the aid of metallic implants in hemifacial microsomia

Does functional appliance treatment truly improve stability of mandibular vertical distraction osteogenesis in hemifacial microsomia?

“…While some authors (Murray et al, 1979;Kaban et al, 1988) consider the disease a progressive one, as the ''rate'' of growth of the affected side does not parallel that of the non-affected side. Other authors stress the fact that the angular asymmetry in these patients is maintained with time, as the ''ratio'' between affected and non-affected sides is constant during growth (Rune et al, 1983;Polley et al, 1997). What seems correct is that HFM patients show an identical angle of asymmetry throughout the whole growth period, as the affected side grows at a slower rate.…”

Comparison of mandibular vertical growth in hemifacial microsomia patients treated with early distraction or not treated: Follow up till the completion of growth

“…While some authors (Murray et al, 1979;Kaban et al, 1988;Kearns et al, 2000) consider the disease a progressive one, requiring early surgical treatment, others do not consider HFM a progressive disease, as the ratio between affected and non affected side is constant during growth (Obwegeser, 1974;Rune et al, 1983;Polley et al, 1997). To demonstrate progressiveness of a disease it is required to longitudinally follow non treated patients (Polley et al, 1997;Rune et al, 1983).…”

Mandibular distraction osteogenesis in hemifacial microsomia: Long-term follow-up

“…But is there truly an inhibition of maxillary growth by the mandible or is there an intrinsic growth defect within the maxilla as part of the birth defect? Rune et al (1983) observed in 11 untreated patients with hemifacial microsomia that, generally, 'the displacement of the maxillary bones corresponded with the displacement of the mandible'. Meazzini et al (1996) in 26 untreated patients with an average follow-up of over 13 years, showed that the angular asymmetry both of the dentoalveolar process and of the skeletal base of the maxilla, remained unaltered with time starting at birth (records were available at age under 1 year, before teething).…”

“…There is much confusion around the terms 'ratio' and 'rate', and this also includes the longstanding controversy on the postulated 'progressiveness' of hemifacial microsomia. While some authors (Murray et al, 1979;Kaban et al, 1988;Padwa et al, 1998) consider the disease a progressive one, as the rate of growth of the affected side does not parallel that of the non-affected side, other authors stress the fact that the angular asymmetry in these patients is maintained with time, as the ratio between affected and non-affected sides is constant during growth (Obwegeser, 1974;Rune et al, 1983;Polley et al, 1997). We have the impression that patients who show an identical angle of asymmetry throughout the whole growth period only grow at a slower rate on the affected side, because, geometrically, if the growth rates were the same, the angle would improve substantially with time (Grayson et al 1997(Grayson et al , 1998.…”