Management of Facial Asymmetry

Abstract

Introduction: When satisfactory correction of facial deformities and asymmetries are unobtainable by dental orthopedics alone, maxillomandibular surgery or double-jaw surgery is often indicated. As orthognathic surgery has been refined, it has become evident that some problems are beyond treatment in a single jaw. The purpose of this study was to present a review of the literature on the etiology, clinical assessment procedures, radiographic diagnostic techniques, and surgical treatments for mandibular and facial asymmetry. A photographic case report is also presented. Materials and Methods: Literature review and case report. Results: The indications for bimaxillary surgery are severe deformities untreatable in one jaw, deformities of both jaws, unfavorable movement prone to relapse, and complex 3D movements where single-jaw surgery would be a functional/cosmetic compromise. Conclusions: The most important aspects of maxillomandibular surgery are not the surgery itself but understanding the indications and the treatment plan, and maintaining stable reference during surgery. Combining osteotomies of the maxilla and mandible is complicated and perhaps associated with increased morbidity. However, when indicated, the combined osteotomy offers more surgical options and better results without functional or cosmetic compromises than single-jaw osteotomy.