Treatment of Skeletal Mandibular Asymmetry without Orthognathic Surgery

Most of the facial asymmetry cases are indications of orthognathic surgeries. However, in the case of patients refuse the treatment plan including a surgical component, the orthodontists try to correct the occlusion without surgical intervention. This case report describes a transfer patient of 12-years-old girl who exhibited mandibular asymmetry and had already commenced the orthodontic treatment with four premolars extraction. Our rediagnosis revealed the difficulty of correcting her skeletal problem only with orthodontic treatment. While we proposed a new treatment plan, she hoped for continuance without surgical procedure. We decided to continue the treatment and noted the following points to achieve minimum requirements in an occlusion.1. Geometrical relation between skull and mandible.2. Mandibular rotation resulted from growth and treatment.3. Limitation of upper anterior teeth movements by intermaxillary suture.An appropriate occlusion was obtained as a result of the precise mechanotherapy, and a good occulsal relationship had been maintained during the retention period.The patients worsen the facial asymmetry almost show some symptoms at the early mixed dentition. Therefore, careful observations and diagnosis are important before orthodontic treatments.