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Three-dimensional Hemifacial Microsomia Classification with New Subtypes Based on the Pruzansky and Kaban
Reiko Shibazaki-Yorozuya1, Akira Yamada2, Ryo Sasaki3
1From Division of Orthodontics, Incorporated Medical Institution, Yorozuya Dental Office, Tokyo, Japan.
Plastic and Reconstructive Surgery. Global Open
|May 29, 2024
Summary
This study introduces a 3D update to the Pruzansky and Kaban classification for hemifacial microsomia (HFM). It identifies retroflexed mandibular condyle subtypes, potentially aiding in predicting mandibular growth.
Area of Science:
- Craniofacial surgery
- Medical imaging
- Orthodontics
Background:
- Hemifacial microsomia (HFM) classifications exist, but some rely on 2D outlines for 3D data.
- Existing classifications may not fully capture the complex 3D morphology of the mandibular condyle in HFM.
Purpose of the Study:
- To investigate the three-dimensional (3D) characteristics of the mandibular condyle in hemifacial microsomia (HFM).
- To update the Pruzansky and Kaban classification system using 3D imaging data for improved accuracy.
Main Methods:
- Computed tomographic (CT) scans of 53 HFM patients were analyzed using the Pruzansky and Kaban classification.
- 3D reconstructions of the mandible were generated to observe condyle characteristics and measure inclination angles.
Main Results:
- New 3D subtypes, IIAβ and IIBβ, were identified, characterized by a retroflexed mandibular condyle.
- These subtypes were observed in 33.3% of type IIA and 100% of type IIB cases.
- Significant differences in condyle inclination were noted, particularly in the new 3D subtypes compared to controls.
Conclusions:
- The retroflexed mandibular condyle, identified as subtypes IIAβ and IIBβ, is a novel finding not discernible in 2D imaging.
- The Pruzansky and Kaban classification is proposed to be updated as a 3D system incorporating these new subtypes.
- The angle of the retroflexed mandibular condyle may serve as a predictor for mandibular growth in HFM patients.
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