Occlusal Plane Correction to Maintain an Esthetic Labiomental Curve

Abstract

Introduction: Facial surgeons commonly treat chin deformities with implants, osteotomies, or osteoplasties. The soft tissue of the chin, specifically the labiomental curve seldom receives attention. The placement of a chin implant or osteotomy to move chin projection to an ideal position can cause an excess labiomental curve or unesthetic labiomental fold. Likewise, a reduction genioplasty to decrease chin projection can adversely flatten an ideal labiomental curve. Rotating the maxillary occlusal plane with orthognathic surgery can prevent this undesirable result or operated-on look. Methods: During treatment planning of patients with “micro or macrogenia” the labiomental curve is assessed. Patients are diagnosed with a normal, low, high and/or dual occlusal plane. Standard cephalometric analyses and evaluation of profile photographs are used to determine ideal chin projection. Patients undergo bimaxillary orthognathic surgery to achieve optimal occlusion, tooth exposure with smiling, and ideal paranasal and lip esthetics without adversely affecting the labiomental curve. Results: Rotation of the maxillomandibular complex by manipulating the occlusal plane has resulted in optimal chin esthetics. The preoperative favorable labiomental curve is unaffected, thus preventing the adverse flat or excess labiomental curve or fold and operated-on look. Conclusions: In order to present chin esthetics in patients who have an ideal labiomental curve, surgeons should consider altering the occlusal plane with orthognathic surgery.