Surgical Orthodontic Treatment for Skeletal Class I with Facial Asymmetry and Occlusal Cant: A Case Report

Ryusuke Yamada,Tsuyoshi Shimo,Shigehiro Takeda,Miki Okayama,Masahiro Iijima

doi:10.2174/1874210602115010644

Abstract

Background: Cases of facial asymmetry with chin deviation and canted occlusal plane represent a challenge in orthodontic treatment. Case Report: We report successful surgical orthodontic treatment for skeletal Class I with severe facial asymmetry. Miniscrew anchorage was used to decompensate the canted occlusal plane in presurgical orthodontic treatment with a fixed appliance by the intrusion of the maxillary right molars and extrusion of the left molars. Then, orthognathic surgery consisting of bilateral sagittal split osteotomy for asymmetric mandibular setback was performed. Treatment resulted in marked improvement of facial asymmetry. Conclusion: The use of miniscrew implant anchorage may represent a superior presurgical orthodontic treatment and expand the possibility of treatment by one-jaw surgery.

Highlights

Cases of facial asymmetry with dental midline and chin deviations represent challenges in orthodontic treatment [1]
If the maxillary asymmetry is limited to a mildly canted occlusal plane, correcting the occlusal plane using a fixed appliance combined with miniscrew implant anchorage makes minimally invasive treatment possible by simpler onejaw mandibular surgery rather than complex mandibularmaxillary two-jaw surgery
We describe successful surgical orthodontic treatment for skeletal Class I with severe facial

Summary

Introduction

Cases of facial asymmetry with dental midline and chin deviations represent challenges in orthodontic treatment [1]. Recent case reports have described the successful use of a miniscrew implant to correct a canted maxillary occlusal plane in conjunction with orthodontic/orthognathic surgery therapy [12, 13]. If the maxillary asymmetry is limited to a mildly canted occlusal plane, correcting the occlusal plane using a fixed appliance combined with miniscrew implant anchorage makes minimally invasive treatment possible by simpler onejaw mandibular surgery rather than complex mandibularmaxillary two-jaw surgery. Cases of facial asymmetry with chin deviation and canted occlusal plane represent a challenge in orthodontic treatment. Miniscrew anchorage was used to decompensate the canted occlusal plane in presurgical orthodontic treatment with a fixed appliance by the intrusion of the maxillary right molars and extrusion of the left molars.

Results

Discussion

Conclusion