Objectives: Skeletal mandibular asymmetry is one of the most evident malformations of the face, because it alters the lower third of the face. In general orthognatic surgery is necessary for adult dental laterodeviation. The aim of this case report was to reveal the efficacy of non surgical orthodontic treatment in a patient with skeletal mandibular asymmetry.
Methods: A 20 year-old female adult patient with skeletal mandibular asymmetry and pain in right TMJ was referred to our clinic. Clinical and radiological examination showed mandibular midline displacement, left unilateral cross bite due to dental maxillary constriction and hemimandibular hyperplasia of the right side of mandible. Cephalometric evaluation revealed Class III skeletal malocclusion with normal vertical growth pattern and proclined upper and lower incisors. The patient declined orthognathic surgery approach, therefore non surgical non-ex orthodontic treatment was planned. At the beginning only upper brackets were bonded and broad upper arch wires were used to correct the crossbite with lower .040 inch essix appliance used to open the bite. After lower arch levelling and aligning, at the finishing stage full time Class III, midline and Class II elastics were worn by the patient to correct the midline deviation and asymmetry.
Results: After 18 months, mandibular asymmetry and TMJ pain was eliminated. At the end of the treatment, Class I occlusion was obtained with balanced functional occlusion and more pleasant facial esthetics.
Conclusion: Appropiate orthodontic treatment approach with patient cooperation in the correction of skeletal mandibular asymmetry in this borderline surgical case was performed successfully.