Vertical non-surgical asymmetry may have an obvious local origin, for instance, a unilateral damage to a nerve.
But usually, there is no evident origin. Frequently, the occlusal slippage of a severe sagittal or a vertical malformation, which may evolve as a borderline surgery case, is suspected to be the real cause. In these cases, the diagnosis is always late, with the ending growth.
The treatment needs peculiar strong asymmetric mechanics and, sometimes, unilateral mixed extractions. The post-treatment occlusion can be unstable ; for this reason, the finishing steps must be carefully conducted. Four clinical case reports develop these points of view.