Open AccessCorrection of severe facial asymmetry: A case with fractured condyle
Author(s) -
Ramesh Agrawal,
Dolly Patel,
Bhagyashree B Desai
Publication year - 2019
Publication title -
apos trends in orthodontics
Language(s) - English
Resource type - Journals
eISSN - 2321-4600
pISSN - 2321-1407
DOI - 10.25259/apos-9-1-10
Subject(s) - facial symmetry , condyle , malocclusion , medicine , chin , occlusion , orthodontics , sagittal plane , dentistry , surgery , anatomy
The current paper depicts the challenges faced during the treatment of a complicated case of mandibular condylar head fracture, facial asymmetry, and centric relation-centric occlusion (CR-CO) discrepancy along with Class III malocclusion. A 20-year-old female reported with the chief complaint of difficulty in chewing and concern with her appearance due to deviated jaw and had a history of trauma over chin region. The clinical and radiographic examination revealed significant facial asymmetry with long face, right-sided deviation of the mandible, fractured condyle, CR-CO discrepancy, cross- bite with Class III malocclusion, and a missing mandibular single incisor along with non-vital 21 and 22. She was treated with 0.022 MBT appliance along with guiding plane for CR-CO correction followed by asymmetric bilateral sagittal split osteotomy and differential set back on the right and left sides and finally rigid fixation. A good facial profile and functional occlusion were achieved and non-vital 21 and 22 were esthetically rehabilitated with PFM crowns. The stability of surgical as well as orthodontic corrections was excellent and appreciable in the records obtained 2-year post-treatment. When faced with mutilated malocclusion, with multiple problems, sequential correction of functional malocclusion with dental decompensation followed by skeletal correction with surgical approach has yielded a appreciable facial correction with good stability showing 2-year post-treatment follow-up.