Asymmetrical malocclusions are frequent orthodontic complications that are difficult to treat effectively. Ideal therapeutic results are primarily based on earlier identification of the asymmetrical malocclusions, precise judgment and treatment planning. Most investigators have recommended treatment approaches by means of asymmetrical mechanics, asymmetrical extractions, surgical improvement of dentofacial asymmetries, distraction osteogenesis and the use of orthodontic miniscrews in asymmetrical corrections. The influence of synchronized facial and dental midlines to an effective orthodontic outcome and good facial balance is undeniable. Even though negligible asymmetries are included within the range of clinical tolerability, massive skeletal and dental imbalances from the facial midline can strongly compromise a pleasing aesthetic outcome.