Intraoral craniofacial manipulation

This case report demonstrates how to use intraoral mechanics to correct facial planes that are not parallel, namely the eye plane, ear plane and occlusal plane. Currently, our protocol states that the cranial and occlusal planes are treated first, followed by expanding (transversely or sagittally), if necessary, the maxillary arch to accommodate the dentition. This creates the template from which the remaining treatment will be rendered, which would include, proper TMJ position, correction of mandibular facial asymmetries that result from ramus growth deficiencies, (both frontal and profile), and determining the correct posterior vertical. At this point the case is in a Class I osseous relationship with all expansion completed. The teeth are then erupted into the correct positions for the orthodontic finishing of the case.