Dental maturation in hemifacial microsomia

Hemifacial microsomia (HFM) is a congenital syndrome in which the mandible shows a spectrum of severity of malformation. The malformation is generally unilateral but may be bilateral, and if so, is then usually asymmetrical. Eighty-nine patients (58 males and 31 females) with unilateral HFM were evaluated for mandibular tooth development using the technique of Demirjian and Goldstein [1976]. According to Pruzansky's classification of severity of malformed mandibles in HFM [1969], the study sample consisted of 57 grade I cases, 26 grade II cases, and 6 grade III cases. Tooth development patterns of the affected and non-affected sides were compared with one another using 45 degrees oblique cephalometric radiographs. Eight cases were studied separately, since three showed bilateral congenital absence of the second premolar, three showed unilateral congenital absence of the second premolar on the affected side, and two had the first permanent molar extracted. In spite of the difference in severity of mandibular anomalies in each group, 45.7% (37) of the patients showed symmetry of tooth maturation. Of the 54.3% (44) patients showing asymmetric tooth maturation, 54.4% (24) showed more advanced dental maturation on the affected side and 45.5% (20) showed more advanced dental development on the non-affected side. These findings suggest that the mandibular deformity associated with HFM does not have an effect on dental maturation when compared with the antimere of the non-affected side.