Effects of functional therapy in patients affected by craniofacial microsomia: a retrospective study

Background/Objectives: Craniofacial microsomia (CFM), previously known as hemifacial microsomia, is a congenital condition involving structures derived from the first and second pharyngeal arches. CFM is characterized by asymmetrical craniofacial growth, affecting the mandible, ear, orbit, soft tissues, and facial nerve. Functional therapy is among the treatment options for mild to moderate cases. This study aimed to assess the effect of functional therapy on mandibular growth in patients with CFM by comparing mandibular and condylar height on the affected and unaffected sides, using pre- and post-treatment panoramic radiographs. Methods: A retrospective longitudinal study was conducted on 14 patients treated with functional therapy with the Asymmetrical Functional Activator (AFA) appliance. Mandibular ramus height (Co-Go) and condylar height (Co-Is) were measured bilaterally on pre- (T0) and post-treatment (T1) panoramic radiographs. Growth differences and rates were analyzed using descriptive and inferential statistics. Results: A significant increase in the mandibular ramus height (Co-Go) and in condylar height (Co-Is) was observed on the affected side from T0 to T1. The increase in mandibular ramus height was significantly greater on the affected side compared to the unaffected side (p = 0.0016). Although condylar height increased significantly on both sides over time, the difference in growth rate between sides was not statistically significant (p = 0.7148). Conclusions: Functional therapy may contribute to reducing mandibular asymmetry in CFM patients by enhancing the growth of the affected mandibular ramus, but the asymmetry may still be present at the end of treatment. These findings support its use in the early management of mild to moderate CFM.