Orthopedic and orthodontic treatment of Parry-Romberg syndrome

Parry-Romberg syndrome (PRS) is a degenerative disease characterized by progressive hemifacial atrophy of soft and hard tissues. A 10-year-old girl who had been treated for linear scleroderma at the dermatologic department since the age of 9 years visited the orthodontic department. The frontal facial photograph showed mild facial asymmetry. On the left side, mild atrophy of soft tissue, mild enophthalmos, cheek depression, and dry skin with dark pigmentation were observed. The radiograph showed hypoplasia of both the maxilla and mandible on the left side. Intraorally, she was in the mixed dentition with the dental crowding. This case report describes the treatment of a patient with PRS for 7 years. To minimize the effect of progressive atrophy on facial growth, a functional appliance was used. The facial photographs and radiographic records were periodically taken to analyze the progression of PRS. Although it is impossible to prevent the progress of facial asymmetry, it appears to be possible to limit the atrophic effect on the mandible by stimulating the mandibular growth. After stabilization of PRS, orthodontic treatment by fixed appliance was performed. In addition, autologous fat graft was performed 3 times at 6-month intervals. After the treatment, the patient had a confident smile, and facial asymmetry was improved.