The authors present a well-done investigation that composes conventional radiographs with photographs, aiming at a better three-dimensional treatment of orthognathic and maxillofacial patients. Indeed, the problems involved in the detection and treatment of facial asymmetry, with all its functional and esthetic implications, are of great interest for orthodontists, oral and maxillofacial surgeons, and dentists. Nevertheless, the study has some shortcomings. I have some perplexities about the necessity of using PA radiographs to measure the occlusal plane. I believe that the same quantitative assessment could be performed on standardized frontal photographs, thus avoiding all the postural problems of posteroanterior (PA) radiographs, and limiting the radiation exposure. For example, in the protocol used by Ferrario et al,’ the subjects were photographed while clenching on a Fox plane between their posterior teeth. The interpupillary plane was taken as the intrinsic horizontal reference. This plane has an advantage, being almost horizontal in all individuals’ (ie, it could be used as an approximation of the true horizontal plane). Moreover, lingual and buccal molar cusps are not located on the same horizontal plane (in the frontal plane they describe Wilson’s curve’); the authors did not specify on which cusps the plane was established. Figure 5 is not discussed in detail in the text. It seems that the percentage of correctly detected occlusal cants rises almost linearly up to 6”, and then it goes down at 7”. A further increment corresponds to go. The behavior of this variable is strange, and a detailed discussion, together with some possible interpretations would allow a better assessment of the value of the proposed method. The authors discuss the cultural background of their panel, but the addition of lay people (ie, outside the medical and dental professions) could have enhanced the significance of the investigation. Indeed, facial asymmetry also has esthetic implications, and recognition of the “ordinary people” threshold for occlusal canting would be additional useful data in the treatment planning of borderline patients.3*4 Finally, a further development of the study could be the detection of the functional threshold of muscular asymmetry,’ as well as the functional correlates of the different degrees of morphologic asymmetry.