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Korean J Orthod. 2017 May;47(3):195-206. doi: 10.4041/kjod.2017.47.3.195. Epub 2017 Mar 13.

Targeted presurgical decompensation in patients with yaw-dependent facial asymmetry.

Author information

1
Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Korea.
2
Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Korea.
3
Private Practice, Seoul, Korea.
4
Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Korea.

Abstract

Facial asymmetry can be classified into the rolling-dominant type (R-type), translation-dominant type (T-type), yawing-dominant type (Y-type), and atypical type (A-type) based on the distorted skeletal components that cause canting, translation, and yawing of the maxilla and/or mandible. Each facial asymmetry type represents dentoalveolar compensations in three dimensions that correspond to the main skeletal discrepancies. To obtain sufficient surgical correction, it is necessary to analyze the main skeletal discrepancies contributing to the facial asymmetry and then the skeletal-dental relationships in the maxilla and mandible separately. Particularly in cases of facial asymmetry accompanied by mandibular yawing, it is not simple to establish pre-surgical goals of tooth movement since chin deviation and posterior gonial prominence can be either aggravated or compromised according to the direction of mandibular yawing. Thus, strategic dentoalveolar decompensations targeting the real basal skeletal discrepancies should be performed during presurgical orthodontic treatment to allow for sufficient skeletal correction with stability. In this report, we document targeted decompensation of two asymmetry patients focusing on more complicated yaw-dependent types than others: Y-type and A-type. This may suggest a clinical guideline on the targeted decompensation in patient with different types of facial asymmetries.

KEYWORDS:

Decompensation; Facial asymmetry; Mandibular yaw; Orthognathic surgery

Conflict of interest statement

The authors report no commercial, proprietary, or financial interest in the products or companies described in this article.

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