Use of modified functional appliances for the correction or amelioration of facial asymmetry and joint dysfunction in post adolescents and adults.

Correction of mandibular deviation (facial asymmetry) and temporomandibular joint dysfunction in the adult patient is possible using modified "twin block" appliances. Final occlusal detailing involves fixed appliances. The method incorporates arch development and correlation together with dental decompensation with mandibular repositioning. Facial appearance is markedly enhanced. In mandibular deviation, (facial asymmetry), the condyle on the side to which the mandible deviates, rotates and moves slightly backward. The condyle on the balancing side moves down the eminence opening the vertical dimension on that side and allows excess maxillary posterior tooth eruption. This lengthens the face on the balancing side and gives rise to the typical can't of the occlusal plane. The condition is almost always due to maxillary arch constriction with tapering form (Division I), or upper incisor retro-inclination (Division II). It is hypothesized that negative pressure from joint distraction allows for advantageous fossa and condyle remodelling, disc recapture or pseudo-disc formation.