Abstract
Symmetry is an important factor affecting facial attractiveness. The majority of subjects with facial asymmetry also exhibit Class III (CIII) malocclusion. However, the method used for three-dimensional analysis of facial asymmetry remains controversial. The optimal symmetry plane (OSP) method was developed to eliminate the identification errors that occur when using traditional orthodontic landmarks. Orthodontic treatment can become complicated in the presence of mandibular second molar impaction. Several parameters should be taken into consideration during the treatment planning, such as position of impacted tooth relative to anatomical structures and adjacent tooth and preexisting conditions in the impacted teeth. In this report, we discuss a relative rare case of skeletal CIII malocclusion with facial asymmetry and horizontal deep impaction of the lower second and third molars. We show how we used the OSP method to identify the facial asymmetry and guide the surgical plan. We also discuss treatment considerations and mechanisms for dealing with horizontal impacted lower molars.
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