Orthodontic and surgical treatment of facial asymmetry in a patient with unicoronal craniosynostosis

This case report presents the unique treatment of a patient with varying asymmetries at different levels within the face. The patient was a 17-year-old male with a diagnosis of right unilateral coronal synostosis. He had frontal and superior orbital retrusion on the fused side, and bossing of the co...

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Bibliographic Details
Published in:American journal of orthodontics and dentofacial orthopedics 2020-02, Vol.157 (2), p.259-268
Main Authors: Wu, Tingxi, Reese, Patricia, Lee, Justine C., Kerayechian, Navid, Martz, Martin, Solem, R. Christian
Format: Article
Language:English
Subjects:
Adolescent
Craniosynostoses - complications
Craniosynostoses - surgery
Dentistry
Esthetics, Dental
Facial Asymmetry - surgery
Facial Bones
Humans
Male
Osteotomy, Le Fort
Citations: Items that this one cites
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Summary:This case report presents the unique treatment of a patient with varying asymmetries at different levels within the face. The patient was a 17-year-old male with a diagnosis of right unilateral coronal synostosis. He had frontal and superior orbital retrusion on the fused side, and bossing of the contralateral side. The middle and lower portions of his face were rotated toward the nonfused side. This unique diagnosis presented particular challenges to surgical and orthodontic correction. The treatment approach, which included a combination of Le Fort I and II osteotomies, bilateral sagittal split osteotomy, and orthodontic treatment with 4 premolar extractions, enabled simultaneous correction of nasal, midfacial, lower facial, and dental asymmetries. The orthodontist and surgeon integrated their efforts to correct dentofacial asymmetry in all 3 planes of space. Facial esthetics and dental function were significantly improved with no appreciable relapse occurring over a 2-year retention period. •The patient had right unilateral coronal synostosis with multiple complications.•The unique presentations included varying asymmetries at different levels within the face.•Treatment included Le Fort I and II and bilateral sagittal split osteotomies, and 4 premolar extractions.•Nasal, midfacial, lower facial, and dental asymmetries were corrected simultaneously.•Facial esthetics and dental function improved significantly.
ISSN:0889-5406
1097-6752
DOI:10.1016/j.ajodo.2018.10.028