Facial asymmetry, defined as difference in the size, shape, or relationship of two sides of the face, has high correlation with facial harmony, attractiveness, and beauty. Unfortunately, prominent abnormalities of the facial structures play an important role in a growing individual’s developing identity and often create undesired psychological results. Mandibular set back and rotation surgery has been performed for the treatment of severe facial asymetry and mandibular prognathy cases to obtain stability of occlusion after treatment.
Methods:
The patient was 20 years old male with concave facial profile, and chin protrusion. The patient had an angle Class III malocclusion with anterior crosbite(-3mm overjet), excessive mandibular laterognaty(4mm) mandibular protrusion, severe openbite(-4mm overbite). The lateral cephalometric analysis indicated a skeletal Class III jaw relationship with an ANB angle of -2.1º After leveling stage, rigid archwires were used to correct the incisor and molar inclinations. Meanwhile, Class II elastics were used for retracting the upper teeth and protracting the lower teeth and, as a result, decompensating the dental relationship. Just before surgery, 0.017 * 0.025 inch stainless steel archwires with surgical spurs were applied. By BSSO; the mandible was rotated 4,5mm to right, moved 1mm forward in right side, 5mm backwards in left side. And for bite correction mandible was rotated 3mm upwards. After surgical phase, Class III elastics with vertical component and anterior box elastics were applied to obtain a good Class I molar and canine relationship and a normal overbite and overjet. Postoperative orthodontic treatment lasted 6 months.
Results: As a result of the orthodontic and orthognathic procedures, the asymmetry of the mandibular body and face was largely eliminated. The open bite was corrected. A favorable occlusal result was achieved with acceptable interdigitation and incisor relationship.
Conclusions:
Surgical orthodontic treatment combined with BSSO can achive more stable, aesthetic, and functional results.