Abstract
Dentofacial deformities (DFD) presenting mainly as Class III malocclusions that require orthognathic surgery as a part of definitive treatment. Class III patients can have obvious signs such as increasing the chin projection and chin throat length, nasolabial folds, reverse overjet, and lack of upper lip support. However, Class III patients can present different facial patterns depending on the angulation of occlusal plane (OP), and only bite correction does not always lead to the improvement of the facial esthetic. We described two Class III patients with different clinical features and inclination of OP and had undergone different treatment planning based on 6 clinical features: (I) facial type; (II) upper incisor display at rest; (III) dental and gingival display on smile; (IV) soft tissue support; (V) chin projection; and (VI) lower lip projection. These patients were submitted to orthognathic surgery with different treatment plannings: a clockwise rotation and counterclockwise rotation of OP according to their facial features. The clinical features and OP inclination helped to define treatment planning by clockwise and counterclockwise rotations of the maxillomandibular complex, and two patients undergone to bimaxillary orthognathic surgery showed harmonic outcomes and stables after 2 years of follow-up.
Highlights
The exact prevalence of significant dentofacial deformities (DFD) that requires orthognathic surgery as a part of definitive treatment is not quite clear [1]
It was estimated that about 5% of the UK or USA population present with DFD that had needed orthognathic surgery as a part of their definitive treatment [2, 3]
The bimaxillary orthognathic surgeries in both patients had been performed by alterations of occlusal plane (OP), which proved to be a useful tool of planning to obtain favorable results
Summary
The exact prevalence of significant dentofacial deformities (DFD) that requires orthognathic surgery as a part of definitive treatment is not quite clear [1]. Marlière et al [13] and Parente et al [14] showed three clinical cases in Class III patients with different facial types and clinical features that performed different treatment planning in orthognathic surgery by counterclockwise and clockwise rotations of the MMC, but the authors disclosed to be more important the evaluation of the clinical features than clearly the obtainment of OP angulation during treatment planning In these case reports, two Class III patients with different clinical features and inclination of OP were presented, undergone different treatment planning, and submitted to alteration of OP by clockwise and counterclockwise rotations of the MMC for orthognathic surgery correction of DFD
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