Modified bimaxillary distraction osteogenesis: a technique to correct facial asymmetry

Abstract

Aim: To study the efficacy of modified simultaneous maxillary-mandibular distraction to correct facial asymmetry in patients with compensated occlusion and a canted occlusal plane.

Patients and methods: During the period January 1998-December 2003, 15 patients with facial asymmetry (8 male and 7 female, mean age 18 years) were treated using a modified technique of simultaneous maxillary-mandibular distraction. Their facial deformities were caused by hemicraniofacial microsomia (n=6) or ankylosis of the temporomandibular joint (TMJ) (n=9).

Results: The mean (range) gain in mandibular height was 16 (13-22) mm, and increase in elongation 14 (11-18) mm achieved over 11-22 days. Predicted movement on cephalometric analysis correlated closely with the actual distraction (mean accuracy 0.4mm).

Conclusion: Simultaneous bimaxillary distraction osteogenesis is a robust technique that provides the surgeon with the ability to correct facial asymmetry in patients with hemicraniofacial microsomia and those with facial deformity after ankylosis of the TMJ. A cephalometric prediction tracing made before distraction is a reliable guide to the actual distraction needed to correct the facial deformities in these patients.