Skeletal and dental disturbances after facial burns and pressure garments

Pressure garments alter facial growth. We conducted a prospective study of facial growth in children wearing such garments to quantify these skeletal and dental disturbances. Three children with total face masks and three children with devices covering the lower face were studied. Panoramic and cephalometric radiographs were obtained at the start of treatment, approximately 6 months later, and at the end of the treatment. Clinical examinations were performed to document occlusal status and subsequent changes. Total face masks affected maxillary horizontal growth more than vertical growth. Mandibular growth changed from the normal anterior and inferior direction to a more inferior direction. With partial face masks, the most notable change was increased proclination of anterior teeth. Facial growth and the position of anterior teeth appear to be affected by the combination of the extent of the burn and skin graft and the type of pressure garments worn during the time of rehabilitation.