Lower face asymmetry treated by orthognathic surgery in two surgical times

Facial asymmetry due to growth disturbances of the jaws almost always requires orthognathic surgical correction. The cause of facial asymmetry in most cases is trauma to the temporomandibular joint (TMJ) by a condylar fracture or unilateral condylar hyperplasia. Correction of maxillomandibular asymmetries in adults demands a bimaxillary surgical approach and, in many cases, additional soft tissue corrections. The aim of this work is to report a case of a male patient who presented to a private clinic complaining about his facial asymmetry and malocclusion. The clinical examination revealed that the patient had a mouth opening limitation, a rotation of the occlusal plane and a Class II malocclusion with a left side crossbite associated to a mandibular laterality. The radiographic exams showed a condylar asymmetry, with a right TMJ pseudoankylosis, a hyperplasia of the left coronoid and the right condyle, and the right mandibular ramus longer than the left one. The surgical treatment plan established was orthognathic surgery made in two surgical times, with a six months interval between them. The first surgery consisted of maxillary impaction and leveling, with its midline correlation to facial midline, mandibular advancement to initial correction of the laterality and the Class II malocclusion, and graft from left coronoid to the chin site. In the second procedure it was performed new right side sagittal osteotomy and the graft segmentation to correct the remaining asymmetry. The patient is in the postoperative follow-up of two years, with no functional or aesthetics complaints.

Conflict of interest: None declared.

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Feb 5, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Lower face asymmetry treated by orthognathic surgery in two surgical times
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