message board Asymmetric Mandible in 12-Year-Old A case with no easy solution has Townies divided on how to treat this young patient in the short term and in the long term WKC Member Since: 05/19/11 Post: 1 of 41 This patient is a 12-year, 7-month-old female with a high mandibular plane angle and a posterior crossbite. As far as I can tell (after several tries at manipulating her mandible) she does not have a functional shift. Her parents do not know of any trauma and they say she has had her crossbite "as long as they can remember" (but aren't really sure). Her face is asymmetric (lower face off to right). Her right condylar process is significantly shorter than the left and her occlusal plane is tipped down on the left. My original thought was that even if she has surgery later to address her mandibular asymmetry, expanding her maxilla now would still be helpful. She is scheduled to come in next week to fit bands for an RPE. However, I got a little concerned after thinking what might result after correcting the crossbite with an RPE. I can envision a posterior open bite resulting on the left side (and possibly an anterior open bite also). My original thought was (if this happened) to consider trying to extrude the lower left teeth from a TAD on the upper left. But even if I could do this, I would still be extruding the lower left teeth to meet a tilted upper occlusal plane. I'm not sure there are any easy answers for this one, but any insights would be greatly appreciated. ■ 3/2/2016 18 NOVEMBER 2017 // orthotown.comhttp://www.orthotown.com