• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.1
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• pp.77-87
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• 2010

Skeletodental asymmetries are common and asymmetric orthodontic treatments are very difficult to correct successfully. The cause of asymmetries can be the skeletal asymmetry, dental, or functional, or combinations of these causes. Skeletodental asymmetries can be the result of congenital factors, such as hemifacial microsomia and environmental factors, such as trauma. Optimal treatment outcome of the severe facial asymmetry requires the orthognathic surgery. Mild asymmetry problem can be treated by only orthodontic treatment. The orthodontic treatment of asymmetry is usually difficult. Facial asymmetry orthodontic treatment are primarily based on proper diagnosis and careful treatment planning. Side effects of asymmetric elastic to treat midline discrepancies are canted occlusal plane, tipped incisors and unesthetic results. In the management of dental arch asymmetries, the clinician should select the appropriate force system and the appliance design necessary to address the asymmetry while minimizing undesirable side effects. This report presents treatment strategies for the treatment of skeletodental asymmetry. In this case report, the clinical case with midline discrepancies treated by optimal mechanics is described. Through diagnosis and strategic treatment mechanics can obtain proper midline correction with minimal side effects.

• Journal of Dental Rehabilitation and Applied Science
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• v.38 no.4
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• pp.249-256
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• 2022

The implant prosthesis of anterior maxilla requires careful consideration in planning. In order to satisfy both esthetic and functional needs of a patient, fusion of intra-oral scan in Cone-beam computed tomography (CBCT) and facial scan can be considered. Bony structures and soft tissues captured in CBCT and occlusal surfaces of intra oral scan were incorporated into personal characteristics from facial scan. The patient had insufficient buccal bone on maxillary anterior area. The maxillary implants could not be placed on the most ideal position. However, the "top down" approach completed by computer-generated arranging of teeth in implant planning and surgery with surgical guide resulted in esthetically and functionally satisfying result regardless of the limitation. Careful diagnosis with digital technique and the usage of surgical guide resulted in successful surgery and esthetic restoration. The temporary fixed prostheses were designed, restored and evaluated. The patient was not satisfied with the first design of temporary prosthesis, which showed uneven space distribution between teeth due to the position of maxillary implant. The design was modified by changing proximal emergence contours and line angle to alter the perceived since of incisors. The patient was satisfied with the new design of provisional restoration. A digital occlusion analyzer (Arcus Digma II, KaVo, Leutkirch, Germany) was used to measure inherent condylar guidance and anterior guidance of a patient to provide a definitive prosthesis.