Functional status of maxillofacial area in children with asymmetric congenital abnormalities and acquired maxillofacial deformities

Abstract

Aim. To determine the masticatory muscles functional activity change in children with congenital abnormalities of maxillofacial area and acquired maxillofacial deformities at the stages of reconstructive plastic surgery. Methods. 10 children at the age from 10 to 14 years with acquired (1st group - 5 patients with secondary temporomandibular joint osteoarthritis, asymmetric micrognathia) and unilateral congenital maxillofacial deformities (2nd group - 5 patients with I-II branchial arches syndrome, asymmetric micrognathia) were examined. Occlusion parameters and electromyographic features of masticatory muscles were analyzed. Results. Occlusal contact estimation did not reveal any significant differences between the groups. The symmetry of masticatory muscles at teeth clenching was higher in children with acquired asymmetric micrognathia (the index of asymmetry at electromyography 1.95±2.1%) compared to children with congenital asymmetric micrognathia (the index of asymmetry at electromyography 23.06±18.8%), p=0.005. Total activation index of masticatory muscles at electromyography ranged from 143 to 64% in patients with temporomandibular joint osteoarthritis and from 127 to 75% in children with I-II branchial arches syndrome. None of the patients included in the study had any complaints of temporomandibular joint and masticatory muscles condition. This was confirmed by no difference in muscular balance static index in two groups. Nevertheless, in patients with I-II branchial arches syndrome a much more sufficient asymmetry was observed. Orthodontic treatment and reconstructive surgery did not succeed in asymmetry index restoration to normal ranges. Conclusion. In children with symmetric abnormalities and acquired deformities functional status of maxillofacial area can be rapidly restored after reconstructive treatment at well-planned orthodontic rehabilitation; maxillofacial area functional status in patients with unilateral abnormalities can not be fully restored, since muscle asymmetry persists for a long time.