Mandibular deviation and canted maxillary occlusal plane treated with miniscrews and intraoral vertical ramus osteotomy: Functional and morphologic changes

Conventionally, the combination of mandibular and maxillary osteotomy is used to correct both mandibular deviation and maxillary canted occlusal plane. This case report describes functional and morphologic changes after an alternative treatment with miniscrew anchorage instead of maxillary osteotomy. A boy, aged 16 years 5 months, had temporomandibular joint disease symptoms, facial asymmetry with mandibular deviation, and a maxillary canted occlusal plane. The maxillary molars on the right side were extruded 3 mm compared with those on the left side. In addition, there were functional problems: lopsided chewing and asymmetric motion range of the bilateral condyles. After correction of the maxillary canted occlusal plane by intrusion of the maxillary right molars with miniscrew anchorage, the mandibular deviation was corrected with mandibular osteotomy. As the therapeutic result, functional symmetry was achieved in addition to symmetric morphologic changes, suggesting that combination treatment of miniscrew anchorage and mandibular osteotomy is effective for treating patients with mandibular deviation and maxillary canted occlusal plane.