Corrección de asimetría facial con tratamiento ortodóncico quirúrgico. Presentación de caso clínico

Abstract

without any apparent pathological data is hereby presented. Upon interrogation, the patient referred to have had a previous surgical replacement of the left ear lobe. Physical examination revealed a severe facial asymmetry with mandibular deviation to the left side, straight profile, upper lip retrusionand gibbous nose. Intraorally the patient showed crowding, non-coincident dental midlines, squared arches and class III molar and canine relationship with left crossbite. Radiographically all dental organs were present and mandibular asymmetry could be observed. Cephalometric analysis showed skeletal a class III due to maxillary retrusion, vertical growth pattern, left laterognathia, proclination of upper incisors and upper lip retrusion. Treatment consisted of three phases: 1 presurgical orthodontics with 0.018" slot Alexander appliances and an archwire sequence suitable to the problem that the patient presented. Subsequently, surgical phase 2 was initiated with a sagittal osteotomy for bilateral laterognathia correction. During phase 3, postsurgical orthodontics, the case was detailed, muscular patterns were corrected and the occlusion was settled. Treatment was completed in 36 months. The profi le and facial harmony were improved, the positive smile was maintained and the crossbite corrected. Bilateral canine and molar class I was obtained, the dental midlines were centered and arch form was improved as were the overbite and overjet.

Alternativas diagnósticas y de tratamiento para la corrección de asimetrías faciales: Revisión bibliográfica.

“…Aproximadamente el 4% de la población tiene una deformidad dentofacial que requiere tratamiento ortodóncico quirúrgico para corregirla. Las indicaciones más comunes para el tratamiento quirúrgico son las clases II y III esqueléticas severas, y las discrepancias esqueléticas verticales en pacientes que ya no están en crecimiento 35 . El objetivo del tratamiento no es solo mejorar la estética facial y la oclusión funcional, sino lograr la recuperación del sistema estomatognático 36 .…”