Facial asymmetry correction with surgical-orthodontic treatment. Case report

ABSTRACTA case report of a 19-year-old female patient who attended the Orthodontics Department, Faculty of Dentistry, National Autonomous University of Mexico without any apparent pathological data is hereby presented. Upon interrogation, the patient referred to have had a previous surgical replacement of the left ear lobe. Physical examination revealed a severe facial asymmetry with mandibular deviation to the left side, straight profile, upper lip retrusion and gibbous nose. Intraorally the patient showed crowding, non-coincident dental midlines, squared arches and class III molar and canine relationship with left crossbite. Radiographically all dental organs were present and mandibular asymmetry could be observed. Cephalometric analysis showed skeletal a class III due to maxillary retrusion, vertical growth pattern, left laterognathia, proclination of upper incisors and upper lip retrusion. Treatment consisted of three phases: 1 presurgical orthodontics with 0.018” slot Alexander appliances and an archwire sequence suitable to the problem that the patient presented. Subsequently, surgical phase 2 was initiated with a sagittal osteotomy for bilateral laterognathia correction. During phase 3, postsurgical orthodontics, the case was detailed, muscular patterns were corrected and the occlusion was settled. Treatment was completed in 36 months. The profile and facial harmony were improved, the positive smile was maintained and the crossbite corrected. Bilateral canine and molar class I was obtained, the dental midlines were centered and arch form was improved as were the overbite and overjet

Mixoma odontogénico, presentación de caso y revisión de literatura

The odontogenic myxoma is a benign lesion that occurs mostly between the second and fourth decade of life, more frequently in the molar area and with a higher incidence in men than in women (2:1). Histologically, it presents starred and fusiform cells dispersed in a very abundant myxoid matrix. The objective of this article is to report a clinical case of an odontogenic myxoma, as well as a brief review of the literature. Subject: a 39-year-old female patient who attended the Oral and Maxillofacial Surgery clinic due to an increase in volume located in the jaw in the vestibular area between teeth 31 and 44; asymptomatic at palpation, with an evolution of approximately twelve months. An incisional biopsy was performed for the histopathological study. The result of the histopathological study was an odontogenic myxoma, so we decided that the best treatment was a free margin resection and reconstruction plate placement.El mixoma odontogénico es una lesión benigna que se presenta mayormente entre la segunda y cuarta década de vida, con mayor frecuencia en zona de molares y mayor incidencia en hombres que en mujeres (2:1). Histológicamente presenta células estrelladas y fusiformes dispersas en una matriz de aspecto mixoide muy abundante. El objetivo de este artículo es reportar un caso clínico de un mixoma odontogénico, así como una breve revisión de la literatura. Una paciente mujer de 39 años que acudió a la clínica de Cirugía Oral y Maxilofacial por presentar aumento de volumen localizado en mandíbula en zona vestibular entre dientes 31 y 44, asintomática a la palpación, con una evolución de aproximadamente doce meses. Se decidió realizar una biopsia incisional para el estudio histopatológico. El resultado del estudio histopatológico fue mixoma odontogénico por lo que se realizó el tratamiento de resección con márgenes libres y colocación de placa de reconstrucción, así como controles posoperatorios