CBCT Evaluation in a Growing Patient With Mandibular Asymmetry Treated With Rapid Palatal Expander and Frankel-III. Case Report.

Abstract

BackgroundThis study aims to evaluate the development and the compensation mechanisms of the mandibular asymmetry in a growing patient, using Cone Beam Computed Tomography (CBCT). In this case, the menton was deviated on the right, an extremely rare condition, which may be the consequence of a disorder in the mandibular growth. Case presentationThe patient was treated with Rapid Palatal Expander (RPE) and Fränkel Functional Regulator III (FR-3). The initial CBCT was acquired at the beginning of therapy, when patient was 8 years old (y.o), the final CBCT was acquired at the end of the treatment, when patient was 12 y.o. Patient’s CBCT was performed with the head oriented according to the Natural Head Position (NHP); the NHP is a physiological and reproducible posture defined for morphological analysis.The 3D image of the cranium was oriented in the Dolphin software according to NHP posture; the cephalometric measurements were performed in frontal, laterolateral right and left, posteroanterior and submentovertex views in the aforementioned software. The therapy lasted 3.8 years and ended with a significant regression of the mandibular asymmetry from moderate grade (4.2 mm) to slight grade (1.3 mm). Conclusion The left hemi-mandible has grown more than right side, in accordance with the literature, which affirm that in case of deviation of the menton greater than 4 mm, the bone volume increases on the nondeviated side.