Treatment strategies for midline discrepancies

Midline discrepancies are among the most complex and commonly seen problems in clinical orthodontics. Skeletal, soft tissue, and dentoavleolar asymmetries may be present alone or in combination in a patient who has noncoincident midlines. Due to the multifactorial etiology of midline discrepancies, a thorough understanding of the components that may contribute to the problem is essential for a correct diagnosis. The treatment mechanics that are derived from the treatment plan must be biomechanically oriented in order to achieve the desired results without the introduction of adverse side effects. This article discusses strategies to correctly diagnose and treat patients with significant midline asymmetries.