Class III malocclusion with severe facial asymmetry, unilateral posterior crossbite, and temporomandibular disorders

A 22-year-old woman had a Class III malocclusion with severe facial asymmetry, unilateral posterior crossbite, and temporomandibular disorders. A clicking sound was noted in the temporomandibular joint on the posterior crossbite side during jaw opening, and she complained of pain in the masticatory muscles on both sides. The articular disc on the crossbite side was displaced anteriorly without reduction. The patient was treated orthodontically with edgewise appliances and surgically with LeFort I and intraoral vertical ramus osteotomies. The result of the combined surgical-orthodontic treatment was facial symmetry and optimal occlusion. The displaced articular disc moved into a normal position, and most of the temporomandibular disorder symptoms improved. At the 2.5-year follow-up, the temporomandibular joint conditions had been maintained.