Simultaneous maxillomandibular distraction osteogenesis in severe progressive hemifacial atrophy with two distractors

Abstract

Progressive hemifacial atrophy is a rare disorder characterized by an acquired, idiopathic, self-limited, unilateral facial atrophy involving skin, subcutaneous tissue, fat, muscle, and bone. Symmetry and contour restoration are the main treatment challenges. Among many techniques, microvascular reconstruction has been introduced as the gold standard to correct the atrophic deformity. For some patients with severe manifestations, soft tissue reconstruction alone does not obtain the desired outcome. In this series, we used an effective method to restore the severe progressive hemifacial atrophy by simultaneous maxillomandibular distraction osteogenesis with 2 distractors. The results demonstrate an improvement in both the profile and the occlusion plane of the patients with corresponding satisfactory esthetic and functional outcomes. We conclude that the simultaneous maxillomandibular distraction osteogenesis with 2 distractors is an effective method for hemifacial atrophy and bone frame reconstruction, especially ones involved in the discrepancy of the occlusal plane.