Facial asymmetries can be assigned to very different causes. These can be functional or dental asymmetries as well as hemifacial microsomia affecting all components of one side, morphologic asymmetries of the mandible like hemimandibular elongation or hemimandibular hyperplasia, asymmetries due to temporo-mandibular joint disorders, cleft lip and palate and asymmetries due to syndromatic diseases.
In this presentation, the different asymmetries of the mandible with special respect to the hemimandibular elongation and hemimandibular hyperplasia, their characteristics and progress are depicted.
Diagnostic tools like classical radiography and scintigraphy and a scheme for differential diagnosis of functional, dental and skeletal mandibular asymmetries are given and some treatment proposals are made as a function of the severity of the underlying skeletal asymmetry. Different mechanics and their side effects for purely orthodontic compensation like asymmetric torque of the buccal segments, transverse, frontal and asymmetric sagittal forces, Tweed-mechanics and their combination are explained. The possibilities and limits of such compensations are presented by some clinical cases.
