Authors : Abhinav Bhardwaj, Anil Miglani, Monika Gupta
DOI : 10.18231/j.jds.2020.004
Volume : 8
Issue : 1
Year : 2020
Page No : 13-17
Introduction: When degree of facial asymmetry is noticeable, it negatively affects facial and smile
esthetics. It may due to discrepancies in size and position between cranial base and maxilla/ mandible.
Asymmetry due to occlusal interference may result in functional shift of the mandible which usually poses
a challenge. So diagnosis and functional examination are keys to an esthetic and stable outcome.
Objectives: This case report addresses the facial asymmetry in an adult patient who sought for
improvement infacial appearance and occlusion.
Case Description: A 26-year old male patient reported with chief complaint of noticeable facial
asymmetry and irregularly positioned teeth. Clinical examination revealed mild facial asymmetry.
Intraorally patient showed crowding, non-coincident dental midlines, anterior cross bite, missing 23 and
root stump 46. Starting point in diagnosis and treatment of this case was establishing centric relation
through guiding the mandible into centric relation rather than centric occlusion. During functional
examination we observed discrepancyin CR-CO which was confirmed using PA-Ceph in centric rest
position. Treatment was planned as deprogramming splint followed by fixed mechanotherapy. Post muscle
deprogramming we were able to achieve “true” anatomic relationship of the mandible to the maxilla.
Conclusion: Thus, the present case report aims at addressing important aspect of functional examination to
be considered by the orthodontist while reaching an accurate diagnosis and treatment plan in such patient’s
with challenging asymmetry.
Keywords: Centric relation, Asymmetry, Deprogramming.