Additionally, the maxillary cant is relatively minor and secondary to the lack of eruption on the R side, due to the x-bite. However, if left unaddressed, it is likely to get worse over time since the L side can still erupt normally and the right side cannot. Therefore, it becomes a larger asymmetry. Once you have normal buccal OJ, post expansion, the upper right side can erupt or be extruded and there is a distinct possibility that the mandibular position may change. If not, the parents have already been informed about the need for surgery, but it may end up being one-jaw (mandible only) as opposed to the maxilla and mandible if nothing is done now. I would bond and fully decompensate the lower arch (21x25 SS) during expansion to optimize the transverse correction. ■ 3/4/2016 Townies help plan a tough case with no easy answer Search: "asymmetric mandible" With young patients there are often as many problems as there are solutions. See how the community tackled this complex situation. Head to orthotown.com and search "asymmetric mandible"-this message board will be the top result. orthotown.com \\ NOVEMBER 2017 23http://www.orthotown.com http://www.orthotown.com