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Craniofacial microsomia (CFM) is a congenital facial condition that affects the structures derived from the first and second pharyngeal arches. It results in underdevelopment of facial structures, most commonly causing abnormal mandibular growth and morphology. Part 1 of this two-part series outlined the aetiology, classification systems and clinical features of CFM. In this article, we explore the management pathway and treatment approaches that may be undertaken. We highlight the dental and orthodontic involvement in managing patients with CFM.
CPD/Clinical Relevance: For patients with CFM, having an understanding of the overall facial and dental management helps the clinician to plan for dental and orthodontic care.
Article
CFM is a complex three-dimensional deformity that requires an ongoing multidisciplinary approach in its management. Owing to the heterogeneity of the phenotype of facial asymmetry and varying levels of soft tissue deficiency, each patient's management pathway is highly individualized in relation to the extent of involvement of each organ.
Management and the timing of interventions are based on the severity of the case, limitation to function, patient and aesthetic concerns and psychosocial concerns. Functional issues may include problems with the airway, vision, hearing, and speech, feeding, swallowing and growth, oral health, mastication and occlusion and psychosocial, as indicated by the International Consortium for Health Outcomes Measurement tool.1
The multidisciplinary requirement of care necessitates that patients are managed in secondary or tertiary care centres. Comprehensive management requires the involvement of plastic surgery, ear nose and throat surgeons, clinical psychologists, audiologists, speech and language therapists, ophthalmologists, craniofacial surgeons, oral and maxillofacial surgeons, orthodontics, paediatric dentists, and restorative dentists (Table 1).
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