Morphologic skeletal asymmetry, with a Class III skeletal discrepancy, treated without surgical intervention

Abstract

Patient J.S., adult, female, presented with a morphologic skeletal asymmetry of the mandible resulting in a unilateral posterior crossbite, and a Class III skeletal discrepancy characterized by a hyperdivergent facial pattern (FMA, 30 degrees), retrognathic maxilla (SNA, 79 degrees), and compensating maxillary alveolar dental protrusion (1-NA, 7 mm). Maxillofacial surgery was declined. Orthodontic treatment, utilizing the Tweed-Merrifield edgewise technique, widened the maxillary dentition with a combination buccal crown torque and buccal root torque and with lingual crown torque in the mandibular posterior quadrant. Temporomandibular joint symptoms lessened and function improved with orthodontic treatment. The skeletal asymmetry improved and the patient was happy with the result, including her profile and her beautiful smile.