Asymmetries of the Face
The face can be looked at from different angles, but one common way is by dividing it vertically into three parts: the upper, middle, and lower thirds.
- The upper third goes from the top of the head down to the eyebrows.
- The middle third is from the eyebrows to the area just under the nose.
- The lower third, which changes the most, goes from under the nose to the bottom of the chin and mostly shows how the lower jaw is positioned compared to the rest of the face.
Initial Evaluation
When a patient comes in for their first visit, we do a full check-up of their face, how their jaws and teeth fit together, their airway, and the position of their jaw joints (TMJ). This is our standard first step.
At this appointment, we usually take a special 3D X-ray of the skull called a CBCT scan, along with digital scans of the teeth, photos of the face and mouth, and a detailed physical exam. The CBCT scan is done using the latest and safest machine available—called the Planmeca Viso G7—which uses a very low radiation dose (Ultra Low Dose setting).
What is the most common site of the Asymmetry?
Facial asymmetries can occur at various levels. These may include differences between the right and left sides of the face, imbalances between the middle and lower thirds of the face, irregularities within the middle third itself, an uneven position of the lower jaw, or asymmetrical alignment of the teeth in the upper or lower jaw—or both.
These asymmetries can range in scale: from those affecting large regions, such as the entire right and left sides of the face, to more localized differences within facial thirds, or even within specific areas like the dental arches. Interestingly, in some cases, a small discrepancy in tooth position can create the appearance of a significant facial asymmetry. In other cases, even more noticeable asymmetries may have little to no visible effect and go completely unnoticed.
Undiagnosed Asymmetries
Undetected asymmetries are one of the most common reasons for noticeable changes following MARPE (Mini-Implant Assisted Rapid Palatal Expansion) treatment. To ensure precise planning, we dedicate 4 to 5 hours to treatment planning for each case, using multiple levels of advanced digital software.
In addition to using the latest advances and techniques, we operate our own in-house 3D diagnostic and planning center. During the initial evaluation and consultation—typically lasting at least 60 minutes—we thoroughly review all findings and highlight any potential bone or tooth movements to the patient. We carefully explain the treatment sequence in detail and develop a personalized treatment plan tailored to each individual.
Most common Asymmetry
When expanding the maxilla using MARPE (Mini-Implant Assisted Rapid Palatal Expansion), all bite relationships and tooth contacts are altered. The position of the lower jaw (mandible) is entirely influenced by the tooth contacts in the upper jaw (maxilla). Therefore, any changes in the upper jaw’s position will inevitably affect the position of the lower jaw.
As a result, the mandible is usually the first to respond to these changes, adjusting its position in relation to the rest of the face. This shift may be perceived as a facial asymmetry. However, it's important to note that this is a temporary condition and is entirely harmless.
Schedule Your Orthodontic Consultation in Boca Raton or Virtual Consultation if you reside outside of Florida
If you're considering MARPE and want to learn more about how it can transform your face and breathing, don't hesitate to reach out to Dr. Svitlana Koval in Boca Raton. With expertise and compassion, Dr. Koval and the team are dedicated to providing personalized orthodontic care tailored to your needs. Call us today at (954) 600-2056 to schedule your consultation and take the first step towards a better breathing and youthful facial appearance. Your journey to a healthier, more confident you begins here!