orthodontic and surgical management of hemifacial microsomia: what not to do and what we may do, based on long term clinical evidence
Orthodontics in HFM is a highly controversial chapter in the literature. The response of a patient with hemifacial microsomia to functional therapy is modest and limited in time (Vargervick, 1995). Extremely mild forms can be treated with orthopedics and dentoalveolar compensation, by accepting a slight asymmetry, which typically does not involve any aesthetic or psychological problem. In the most severe forms of HFM, if the child experiences psychological problems, distraction osteogenesis is often suggested, but it is fundamental to acknowledge that a gradual return to the initial pattern of asymmetry always occurs (Meazzini., 2005, 2011).
A particular group of patients, often misdiagnosed as HFM, that we defined as pseudo-HFM or CCC syndrome, shows an exceptional response to the Orthopedic treatment, and is more likely that these pseudo-microsomie are not actually true 1st branchial arch syndromes, but most likely very early trauma outcome (Meazzini, 2008; 2010).
Long term results of early surgery and early orthopaedics in true and false HFM will be shown.