Asymmetry

Question 1

the face is _____ totally symmetrical

Answer 1

totally

Question 2

severe asymmetric development of the jaws to cause a problem is:

Answer 2

relatively rare

Question 3

what is one of the most critical aspects in orthodontic diagnosis

Answer 3

a patient’s frontal symmetry evaluation

Question 4

even the most esthetic faces are associated with:

Answer 4

mild forms of facial asymmetry

Question 5

the individuals seeking ortho tx are often associated with:

Answer 5

facial asymmetries that may be greater than the acceptable norms

Question 6

facial asymmetries are _____ prevalent in ortho pts

Answer 6

more

Question 7

what are the classifications of facial asymmetries

Answer 7

• skeletal asymmetries
• functional asymmetries
• soft tissue asymmetries

Question 8

what is a type of mandibular deviation

Answer 8

hyperplastic mandible

Question 9

what is the etiology of mandibular asymmetries

Answer 9

• prenatal causes
• genetic: facial cleft syndromes - unilateral cleft lip- cleft palate
• congenital
• post natal causes
• environmental

Question 10

what are the congenital causes of mandibular asymmetry

Answer 10

-hemi-facial microsomia
- neurofibromatosis
- birth trauma
- intra- uterine pressure during pregnancy

Question 11

what are the environmental causes of mandibular asymmetry

Answer 11

• trauma and infection
• muscle dysfunction
• functional deviations
• TMJ derangements
• hemi mandibular hypertrophy
• pathologies

Question 12

how are asymmetries diagnosed

Answer 12

• medical hx
• clinical exam: intra oral and extra oral exam
• para clinical exam: radiographs, photographic analysis, digital videography, articulated study models

Question 13

what is evaluated in the extra oral eval

Answer 13

• frontal
• vertical
• sub-mento vertex
• the pupils are assessed for level with the horizon
• if level then use as horizontal reference line- inter pupillary plane

Question 14

how do you dx hyperplastic ocndyle

Answer 14

CBCT scans

Question 15

what is examined in intra oral exam

Answer 15

• functional exam: maximal opening, postural rest position, CR-CO discrpepancy, motor and sensory eval
• eval of dental midlines
• unilateral cross bites
• vertical occlusal evaluation
• transverse cant of maxilla

Question 16

what is centric relation

Answer 16

a musculoskeletal stable position with the condyles forward as far upward as possible, centered transversely and with the articular disc properly interposed

Question 17

what is centric occlusion and what is another name for it

Answer 17

• maximum intercuspation
• a dental determined position, tooth morphology and position are the primary influences determining the mandibular position and movements. the condylar position is strongly determined by the dental contacts and intercuspation through muscles and ligaments

Question 18

what is non functional considered

Answer 18

• no Cr-Co shift
• there is a dental or skeletal asymmetry

Question 19

what is the importance of radiographic exam

Answer 19

taking an accurate radiograph is crucial as the head position is an important factor in radiographic assessment

Question 20

we can use different radiographs to evaluate asymmetry such as:

Answer 20

• lateral ceph
• panoramic radiograph
• sub mento vertex view
• CBCT

Question 21

which is the best radiograph for dx

Answer 21

CBCT

Question 22

lower dental midlines will usually have an effect on:

Answer 22

the occlusion

Question 23

asymmetric occlusion =

Answer 23

asymmetric mechanics

Question 24

what is used to correct or improve the developing inbalance

Answer 24

orthopedic appliances and orthodontics
- hybrid functional appliances
- distraction osteogenesis

Question 25

What is the frontal eval measured in

Answer 25

1/5ths
- inner eyes to inner inner eye
- inner eye to outer eye
- outer eye to outer ear

Question 26

what is the vertical eval measured in

Answer 26

1/3rds
- forehead to eyebrowns
- eyebrows to base of nose
- base of nose to the inferior tip of the chin

Question 27

how are asymmetries treated in non growing individuals (adults)

Answer 27

surgical conditions with severe skeletal asymmetries are not able to be corrected by orthodontic camouflage and growth modification so surgical procedures are used to correct the deformities or asymmetries

Question 28

what are the treatments for adults with asymmetries

Answer 28

• distraction osteogenesis
• surgical osteotomy: maxillary surgerys (Le-fort I), mandibular strageties - bilateral sagittal split osteotomy (BSSO), inferior body osteotomy, genioplasty

Question 29

what are the treatments for deviations caused by functional shifts

Answer 29

• mild: minor occlusal adjustments
• moderate to severe deviations: orthodontic treatment to align the teeth

Question 30

what may be indicated in the management of cases where functional shift is the result of skeletal asymmetry

Answer 30

rapid maxillary expansion, orthognathic surgery, orthodontic treatment

Question 31

what is another name for an occlusal splint

Answer 31

deprogrammers

Question 32

what are occlusal splints used for

Answer 32

to properly evaluate the presence and extent of the functional shift by eliminating the habitual posturing and deprogramming the musculature

Question 33

deformities caused by soft tissue imbalance can be treated by:

Answer 33

either augmentation or reduction surgery

Question 34

augmentations include:

Answer 34

the use of bone grafts and silicone implants to re-contour the desired areas of the face