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

Area of Science:

• Orthodontics
• Dentofacial Orthopedics
• Maxillofacial Surgery

Background:

• 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).
• Patient declined maxillofacial surgery.

Observation:

• Morphologic skeletal asymmetry of the mandible leading to unilateral posterior crossbite.
• Temporomandibular joint symptoms and impaired function.

Findings:

• Orthodontic treatment using the Tweed-Merrifield edgewise technique achieved significant improvement.
• Maxillary dentition widened with buccal crown and root torque; mandibular posterior quadrant received lingual crown torque.
• Skeletal asymmetry reduction, improved temporomandibular joint symptoms, and enhanced function.

Implications:

• Non-surgical orthodontic correction is a viable alternative for skeletal asymmetry and Class III malocclusion.
• Improved facial aesthetics and patient satisfaction achieved through conservative orthodontic management.
• Successful management of dentofacial deformities can enhance both function and quality of life.