Correction of a mandibular asymmetry using a custom-made titanium onlay

The diagnosis and treatment of facial deformities, including mandibular asymmetries, can pose a significant clinical problem. The limitations, accuracy and predictability of treatment options available and the expectations of the patient can further compound this. In this article we present a case of facial asymmetry secondary to mandibular angle deficiency corrected by the manufacture and placement of a custom-made titanium onlay. Although alternative methods were potentially available to correct this deformity, patient factors including occlusion, dental/skeletal relationship and chin position limited our options. Furthermore, construction of the custom-made titanium onlay involved the development of a computer-generated 3D virtual model and computer-aided design and computer-aided manufacture (CAD-CAM) of the inlay. This report demonstrates that this technique can be used successfully to address certain cases of facial asymmetry.