A Case of Surgical Orthodontic Treatment of Facial Asymmetry with Vertical Disharmony

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Facial asymmetry is often associated with problems in the horizontal dimension, such as a lateral shift of the mandible, or an asymmetrical shape of the mandibular and/or maxillary bones. A vertical dimensional disproportion, such as a difference in height of the mandibular ramus or alveolar bone, is usually included.<BR>In past years, sagittal split ramus osteotomy has often been preferred for treating facial asymmetry even in cases that are caused by vertical problems. However, it has been difficult to achieve satisfactory improvement of facial asymmetry and stomatognathic dysfunction without correcting vertical problems in many cases.<BR>In this report, we present a facial asymmetry case which is characterized by disproportion in the vertical height of the mandibular ramus with an occlusal cant. This patient underwent unilatera lvertical ramus osteotomy on the shifted side and sagittal split ramus osteotomy on the contralateral side. An acrylic splint was inserted to open the occlusion on the shifted side. The patient was then placed into intermaxillary fixation. After bony healing, the splint was removed and the teeth were allowed to elongate into occlusion. Satisfactory stomatognathic function and facial symmetry were obtained after treatment in this case.
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