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J.-W. Choi, J. Y. LeeThe Surgery-First Orthognathic Approachhttps://doi.org/10.1007/978-981-15-7541-9_13
13. Clinical Application of the Surgery-First Approach to Facial Asymmetry
Facial asymmetrySFATraditional orthognathic surgeryHorizontal facial asymmetryVertical facial asymmetryClassification
13.1 Facial Asymmetry Classification
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Turvey’s classification of facial asymmetry
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1.
Pseudoasymmetry.
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2.
Normal developmental facial asymmetry.
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3.
Unilateral overdevelopment.
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4.
Unilateral underdevelopment or degeneration.
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5.
Craniobasal asymmetry.
13.1.1 Pseudo Facial Asymmetry (Fig. 13.2)
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Pseudoasymmetry is not true facial asymmetry, despite the mandible being asymmetrically positioned. Occlusal interference, habitual posturing, condylar dislocation, or dystonia are potential causes
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An example of pseudoasymmetry where the condyle is displaced relative to the centric relation in the fossa
13.1.2 Developmental Facial Asymmetry (Fig. 13.4)
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Developmental facial asymmetry. Developmental asymmetry is the non-pathologic, non-syndromic development of facial asymmetry
13.1.3 Overdevelopmental Facial Asymmetry (Figs. 13.5, 13.6)
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Overdevelopmental facial asymmetry. Unilateral mandibular hyperplasia is a typical example of overdevelopmental facial asymmetry
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Unilateral mandibular hyperplasia corrected using orthognathic surgery
13.1.4 Underdevelopmental Facial Asymmetry (Figs. 13.7, 13.8)
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Underdevelopmental facial asymmetry
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Underdevelopmental facial asymmetry corrected using yaw and pitch movements of the maxillomandibular complex during surgery-first orthognathic surgery
Congenital underdevelopmental facial asymmetry includes unilateral cleft lip and palate, hemifacial microsomia, and Treacher Collins syndrome. Acquired underdevelopmental facial asymmetry may result from trauma, infection, or ankylosis. Idiopathic condyle resorption (ICR) presents unilaterally and can also cause underdevelopmental facial asymmetry.
13.1.5 Craniofacial Asymmetry (Fig. 13.9)
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