AUTHOR=Macrì Monica , Festa Felice 

TITLE=Three-dimensional evaluation using CBCT of the mandibular asymmetry and the compensation mechanism in a growing patient: A case report

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.921413

DOI=10.3389/fpubh.2022.921413

ISSN=2296-2565

ABSTRACT=Background
This case report aims to evaluate the development and the compensation mechanisms of the mandibular asymmetry in a growing male 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 presentation
The young male 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 the patient was 8 years old (y.o), the final CBCT was acquired at the end of the treatment when the patient was 12 y.o. The 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 software as mentioned above. 
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 the right side, in accordance with the literature, which affirms that in case of deviation of the menton greater than 4 mm, the bone volume increases on the non-deviated side.