Nonsurgical treatment of hemifacial microsomia with an orthopedic functional appliance

Hemifacial microsomia can be genetic, environmental, or mixed, yet most cases result from multifactorial inheritance. Genetic factors include developmental disorders, genetic changes and chromosomal abnormalities. Hemifacial microsomia is a morphological change caused by an abnormal development of the first and second branchial arches. The most important clinical signs are unilateral mandibular hypoplasia, agenesis or malformation of the pinna and agenesis or malformation of the eye. This study presents a case of condylar agenesis treated nonsurgically with an orthopedic functional appliance. The treatment lasted 5 years and significantly reduced facial asymmetry and corrected the crossbite, midline deviation and mandibular growth in the affected side. Early use of functional orthopedics proved to be effective in correcting the facial and skeletal asymmetries resulting from hemifacial microsomia and condylar agenesis. Indexing terms: Orthotic devices. Facial asymmetry. Orthodontics.