Modified bimaxillary distraction osteogenesis: A technique to correct facial asymmetry

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 0.4 mm). 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.