Two-jaw Surgery for Mandibular Asymmetry in a Patient with Unilateral Posterior Crossbite

Abstract

The case of a 16-year-old female patient with the complaint of facial asymmetry and unilateral posterior crossbite was reported before and after two-jaw surgery to evaluate facial cosmetics and occlusion. A pre-surgical orthodontic appliance was inserted immediately after the first examination because her growth was completed. Her mandible was deformed to the left side and lateral crossbite was recognized with a slight clinical symptom of TMD on the left side. Her maxillary first premolars were extracted to correct the axial inclination of the incisors, and her mandibular first premolars were also extracted to eliminate crowding. After 28 months of pre-surgical orthodontics, mandibular set-back surgery (SSRO) and Le Fort I surgery were performed simultaneously. Maxillary deformation was corrected by decreasing the right molar height and by increasing the left molar height. Stable occlusion and successful facial symmetry were achieved, and the fixed appliance was removed 6 months after surgery.
Data of the pressure sensitive occlusal sheet (Dental Prescale®) indicated that the occlusal contact area, occlusal force and occlusal balance improved between the beginning and end of active treatment, and during 1-year retention. The data suggests that improvement was successful, both morphologically and functionally.