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Their Effect on Growth and Dentition

W. Frederick McGuirt, MD; Paul Lee Salisbury, III, DDS

Arch Otolaryngol Head Neck Surg. 1987;113(3):257-261.

Abstract
• Findings in 28 subjects having had childhood mandible fractures with long-term follow-up document asymmetric facial growth and dental abnormality in a high proportion. Facial growth abnormalities, five of which were moderate to severe, were detected by trained medical-dental examiners in 13 of the subjects (47%). Cephalometric abnormalities were detected in 18 (67%) of the 27 subjects so analyzed, with five (18%) meeting multiple roentgenographic criteria for abnormality. Frontal and lateral cephalometric abnormalities were found in nearly equal percentages among condylar-only, condylar-body, and noncondylar fracture groups, but abnormalities were most severe in association with the condylar injuries. The single best screening tool for facial abnormality was clinical examination. Frontal cephalometric roentgenograms correlated with clinical findings better than lateral cephalometric roentgenograms. However, roentgenograms alone had a 35% false-positive incidence of abnormality when correlated with the clinical-dental examination. Abnormalities of occlusion and dentition were seen in ten (36%) of the 28 subjects. Pterygoid muscle exercises following prolonged intermittent, nocturnal, intermaxillary fixation are discussed as a possible means to reduce the incidence of these abnormalities as the child matures.

(Arch Otolaryngol Head Neck Surg 1987;113:257-261)

Author Affiliations
From the Section on Otolaryngology, Department of Surgery (Dr McGuirt), and the Department of Dentistry (Dr Salisbury), Wake Forest University Medical Center, Winston-Salem, NC.

Footnotes
Accepted for publication Dec 15, 1986.

Read before the Spring Meeting of the American Academy of Facial Plastic and Reconstructive Surgery, Palm Beach, Fla, May 10, 1986.

Reprint requests to Section on Otolaryngology, Bowman Gray School of Medicine, 300 S Hawthorne Rd, Winston-Salem, NC 27103 (Dr McGuirt).

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