Abstract
We have classified maxillofacial asymmetry from two viewpoints: the fact that all humans have an asymmetrical face, regardless of whether it appears to be normal and symmetrical, and the ability of humans to visually perceive asymmetry. In this study, based on this classification, we investigated skeletal factors influencing self-recognition after surgery in maxillofacial asymmetry patients, and attempted to apply the factors for mandibular reconstruction. We also investigated the limitation of the fibula with regard to these factors and grafted bone resorption and absolute indications. It was suggested that the positional adjustment of the chin (C: center of the mandible) is important, and that changes in the mandibular angle (A) markedly influence self-recognition of asymmetry in patients of mandibular reconstruction. Considering postoperative recognition of asymmetry, grafted fibular bone resorption, and the importance of preserving the peroneal artery for patients and prepositions towards peripheral arterial disease (PAD), the indication of mandibular reconstruction with a free fibular bone flap should be limited to the mandibular straight-line region (B: body of the mandible) not requiring osteotomy with a conserved mandibular angle.
