Midfacedeplacement

Midfacedeplacement refers to an abnormal positional change of the midfacial skeleton, typically involving the maxilla, zygomatic bones, and adjacent structures, relative to the cranial base or mandible. It can occur in various directions, including forward (anterior), backward (posterior), upward (superior), or downward (inferior), and may involve rotational components. The term is often used in the contexts of trauma, congenital malformations, and postoperative changes after craniofacial procedures.

Causes and contexts include high-energy blunt facial trauma that disrupts midfacial supports, such as Le Fort fracture patterns, as well as congenital conditions that alter midface growth or position. Midfacial displacement can also arise or be perceived after orthognathic surgery or distraction osteogenesis when planned repositioning of the midface is not achieved or is adjusted for functional or aesthetic reasons.

Diagnosis relies on clinical examination and imaging. Clinically, there may be malocclusion, facial asymmetry, ocular or dental issues, or impaired airway function. Imaging—most commonly computed tomography or cone-beam CT, sometimes with 3D reconstructions—assesses the extent of displacement, fracture lines, and overall craniofacial relationships. Cephalometric or other craniofacial measurements may be used to quantify displacement and plan treatment.

Management aims to restore facial balance, function, and occlusion. Treatments range from prompt reduction and internal fixation of displaced fragments in acute trauma to planned orthognathic surgery or distraction osteogenesis for congenital or acquired hypoplasia. Orthodontic therapy may accompany surgical correction to achieve stable occlusion. Prognosis depends on injury severity, timing of intervention, and associated injuries.