{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:35:11Z","timestamp":1787841311473,"version":"build-2784847793"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p>This case report outlines the importance of an interdisciplinary approach and a patient centric outcome for the treatment of facial asymmetry resulting from hemifacial microsomia. Different treatment modalities are available to treat asymmetries. However, the best treatment outcome can be achieved only when the treatment plan is individualized for every patient. This report portrays an adult patient with hemifacial microsomia, who had facial asymmetry from the level of supraorbital region with a Class II skeletal base. Orthodontic treatment, along with surgical management, was required to transform the patient into a symmetrical profile, which is esthetically pleasing. A sound knowledge of the various technologies and resources that are available to us and making the best use of it to bring out a drastic change in the patient's life. Combined effort of the orthodontists and oral surgeons are required to manage patient's with hemifacial microsomia that has caused the severe facial asymmetry. Moreover, special attention has to be given to a patient-centric outcome.<\/jats:p>","DOI":"10.4103\/ccd.ccd_37_20","type":"journal-article","created":{"date-parts":[[2020,12,20]],"date-time":"2020-12-20T02:48:38Z","timestamp":1608432518000},"page":"387-394","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["An Interdisciplinary Management of Severe Facial Asymmetry Due to Hemifacial Microsomia"],"prefix":"10.4103","volume":"11","author":[{"given":"Mary","family":"Sanjana","sequence":"first","affiliation":[{"name":"Department of Orthodontics and Dentofacial Orthopeadics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sivakami","family":"Manikandan","sequence":"additional","affiliation":[{"name":"Department of Orthodontics and Dentofacial Orthopeadics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uma","family":"Maheshwari","sequence":"additional","affiliation":[{"name":"Department of Orthodontics and Dentofacial Orthopeadics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ratna","family":"Parameswaran","sequence":"additional","affiliation":[{"name":"Department of Orthodontics and Dentofacial Orthopeadics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devaki","family":"Vijayalakshmi","sequence":"additional","affiliation":[{"name":"Department of Orthodontics and Dentofacial Orthopeadics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,12,20]]},"reference":[{"key":"R1-20250920","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1590\/2177-6709.20.6.110-125.sar","article-title":"Facial asymmetry: A current review","volume":"20","author":"Thiesen","year":"2015","journal-title":"Dent Press J Orthod"},{"key":"R2-20250920","first-page":"171","article-title":"The prevalence of facial asymmetry in the dentofacial deformities population at the University of North Carolina","volume":"12","author":"Severt","year":"1997","journal-title":"Int J Adult Orthodon Orthognath Surg"},{"key":"R3-20250920","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/S0901-5027(06)80086-X","article-title":"Perspectives of craniofacial asymmetry Part IV","volume":"24","author":"Cohen","year":"1995","journal-title":"Hemi-asymmetries, Int J Oral Maxillofac Surg"},{"key":"R4-20250920","first-page":"2383","article-title":"A series of three case reports","volume":"7","author":"Mishra","year":"2013","journal-title":"J Clin Diag Res"},{"key":"R5-20250920","first-page":"2383","article-title":"Ramanupamtripathy: Hemifacial microsomia: A series of three case reports","volume":"7","author":"Mishra","year":"2013","journal-title":"J Clin Diag Res"},{"key":"R6-20250920","first-page":"241","article-title":"Asimetrias faciales: Ortodoncia y cirugia ortognatica","volume":"3","author":"Colmenero","year":"2010","journal-title":"Gaceta Dent"},{"key":"R7-20250920","first-page":"15","article-title":"Diagnostico de las asimetrias faciales y dentales","volume":"16","author":"Sora","year":"2005","journal-title":"Rev Fac Odont Univ Ant"},{"key":"R8-20250920","doi-asserted-by":"crossref","first-page":"603","DOI":"10.4103\/0972-1363.188772","article-title":"Hemifacial microsomia: A rare case report","volume":"27","author":"Choudhary","year":"2015","journal-title":"J Indian Academy Oral Med Radiol"},{"key":"R10-20250920","first-page":"620","article-title":"Die Missblidungen des ohres","volume":"12","author":"Marx","year":"1926","journal-title":"Handb Spez Pathol Anat Histol"},{"key":"R11-20250920","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1067\/mod.2003.3","article-title":"Panoramic radiographs: A tool for investigating skeletal pattern","volume":"123","author":"Akcam","year":"2003","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"R12-20250920","first-page":"89","article-title":"Dental and facial asymmetries: A review","volume":"64","author":"Bishara","year":"1994","journal-title":"Angle Orthod"},{"key":"R13-20250920","first-page":"1400","article-title":"Diagnosis and management of facial asymmetry","volume":"3","author":"Hegtvedt","year":"1993","journal-title":"Oral and Maxillofacial Surg"},{"key":"R14-20250920","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/S0901-5027(06)80085-8","article-title":"Perspectives of craniofacial asymmetry.Part III Common and\/or well known causes of asymmetry","volume":"24","author":"Cohen","year":"1995","journal-title":"Int J Oral Maxillofac Surg"},{"key":"R15-20250920","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/S0266-4356(97)90408-3","article-title":"A simple classification for surgical planning of maxillomandibular asymmetry","volume":"35","author":"Reyneke","year":"1997","journal-title":"Br J Oral Maxillofac Surg"},{"key":"R16-20250920","first-page":"120","article-title":"Not all dwarfed mandibles are alike","volume":"4","author":"Pruzansky","year":"1969","journal-title":"Birth Defects"},{"key":"R17-20250920","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.ajodo.2013.02.033","article-title":"Adult patient with hemifacial microsomia treated with combined orthodontics and distraction Osteogenesis","volume":"145","author":"Choi","year":"2014","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"R18-20250920","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1177\/0974909820120105","article-title":"Orthopantomographic analysis for assessment of mandibular asymmetry","volume":"46","author":"Gupta","year":"2012","journal-title":"J Ind Orthod Soc"},{"key":"R19-20250920","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1016\/j.ajodo.2008.04.032","article-title":"Use of rhythmic wire system with miniscrews to correct occlusal-plane canting","volume":"137","author":"Kang","year":"2010","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"R20-20250920","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.ajodo.2006.04.016","article-title":"Correction of a canted occlusal plane with miniscrews in a patient with facial asymmetry","volume":"130","author":"Jeon","year":"2006","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"R21-20250920","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/j.ajodo.2014.08.018","article-title":"Correction of facial asymmetry and maxillary canting with corticotomy and 1-jaw orthognathic surgery","volume":"146","author":"Ahn","year":"2014","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"R22-20250920","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/S0889-5406(96)70141-5","article-title":"The performance of bonded magnets used in the treatment of anterior open bite","volume":"109","author":"Noar","year":"1996","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"R23-20250920","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.ajodo.2005.12.032","article-title":"Titanium screw anchorage for correction of canted occlusal plane in patients with facial asymmetry","volume":"132","author":"Takano-Yamamoto","year":"2007","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"R24-20250920","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00006534-199289010-00001","article-title":"Lengthening the human mandible by gradual distraction","volume":"89","author":"McCarthy","year":"1992","journal-title":"Plast Reconstr Surg"},{"key":"R25-20250920","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1097\/00006534-200101000-00050","article-title":"Distraction osteogenesis of the craniofacial skeleton","volume":"107","author":"Gosain","year":"2001","journal-title":"Plast Reconstr Surg"},{"key":"R26-20250920","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.ajodo.2006.12.014","article-title":"Ten-year follow-up of a patient with hemifacial microsomia treated with distraction osteogenesis and orthodontics: An implant analysis","volume":"134","author":"Iseri","year":"2008","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"R27-20250920","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/S0889-5406(00)70223-X","article-title":"Two-year follow-up of distraction osteogenesis: Its effect on mandibular ramus height in hemifacial microsomia","volume":"117","author":"Marquez","year":"2000","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"R28-20250920","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1067\/mod.2001.115149","article-title":"Intrusion of overerupted molars by corticotomy and magnetics","volume":"120","author":"Hwang","year":"2001","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"R29-20250920","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1054\/ijom.2000.0033","article-title":"Craniofacial distraction osteogenesis: A review of the literature: Part 1: Clinical studies","volume":"30","author":"Swennen","year":"2001","journal-title":"Int J Oral Maxillofac Surg"},{"key":"R30-20250920","first-page":"165","article-title":"Treatment of mandibular asymmetry by distraction osteogenesis and orthodontics: A report of four cases","volume":"70","author":"Tehranchi A and Behnia","year":"2000","journal-title":"Angle Orthod"},{"key":"R31-20250920","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/0889-5406(87)90370-2","article-title":"Stability following superior repositioning of the maxilla by LeFort 1 osteotomy","volume":"2","author":"Proffit","year":"1987","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"R32-20250920","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/S1010-5182(87)80060-4","article-title":"Five-year follow-up of LeFort I osteotomies","volume":"15","author":"Iannetti","year":"1987","journal-title":"J Craniomaxillofac Surg"},{"key":"R33-20250920","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/1746-160X-3-21","article-title":"The hierarchy of stability and predictability in orthognathic surgery with rigid fixation: An update and extension","volume":"3","author":"Proffit","year":"2007","journal-title":"Head Face Med"},{"key":"R34-20250920","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0889-5406(03)00562-6","article-title":"Class III malocclusion with severe facial asymmetry, unilateral posterior crossbite, and temporomandibular disorders","volume":"124","author":"Miyatake","year":"2003","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"R35-20250920","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.1016\/j.jcms.2014.06.008","article-title":"Asymmetric mandibular prognathism: Outcome, stability and patient satisfaction after BSSO surgery.A retrospective study","volume":"42","author":"H\u00e5gensli","year":"2014","journal-title":"J Craniomaxillofac Surg"},{"key":"R36-20250920","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/j.ajodo.2012.09.024","article-title":"Improvement of asymmetric stomatognathic functions, unilateral crossbite, and facial esthetics in a patient with skeletal Class III malocclusion and mandibular asymmetry, treated with orthognathic surgery","volume":"144","author":"Takeshita","year":"2013","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"R37-20250920","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1016\/j.joms.2013.04.008","article-title":"Does skeletal surgery for asymmetric mandibular prognathism influence the soft tissue contour and thickness?","volume":"71","author":"Lee","year":"2013","journal-title":"J Oral Maxillofac Surg"},{"key":"R38-20250920","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.ajodo.2016.06.052","article-title":"Orthodontic-surgical retreatment of facial asymmetry with occlusal cant and severe root resorption: A 3-year follow-up","volume":"152","author":"Lisboa","year":"2017","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"R39-20250920","doi-asserted-by":"crossref","first-page":"e126","DOI":"10.11607\/ortho.903","article-title":"Orthodontic and orthognathic management of a complex mandibular asymmetry","volume":"14","author":"George","year":"2013","journal-title":"Orthodontics (Chic)"},{"key":"R40-20250920","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/0278-2391(89)90221-8","article-title":"Condylar displacement and temporomandibular joint dysfunction following bilateral sagittal split osteotomy and rigid fixation","volume":"47","author":"Hackney","year":"1989","journal-title":"J Oral Maxillofac Surg"}],"container-title":["Contemporary Clinical Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ccd.ccd_37_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:48:29Z","timestamp":1787838509000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ccd.ccd_37_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10]]},"references-count":39,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.4103\/ccd.ccd_37_20","relation":{},"ISSN":["0976-237X","0976-2361"],"issn-type":[{"value":"0976-237X","type":"print"},{"value":"0976-2361","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10]]},"assertion":[{"value":"2020-01-14","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-27","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}