Sagittal Relationship Research Articles

Factors related to orthodontic treatment time in adult patients

The length of time that it takes an orthodontist to treat adult patients varies widely. The aim of this study was to investigate how different variables influence treatment time. Seventy clinical case reports of successfully treated adult patients were examined. The patients were selected from 4,723 records held by three experienced orthodontists. The influence exerted by the following variables on treatment time was assessed: age, sex, facial pattern, severity of malocclusion (measured by the PAR index), sagittal relationship of canines, type of brackets (ceramic or metal), tooth extractions, missed appointments and orthodontic appliance issues/breakages, the latter being the dependent variable. Assessment was performed by multiple linear regression analysis, followed by the stepwise method with p < 0.05. The number of times a patient missed their appointment (no-show) (R² = 14.4%, p < 0.0001) and the number of appliance issues/breakages (R² = 29.71%, p = 0.0037) significantly affected variability in treatment time, and these two variables together can predict 43.75% (R² total) of the overall variability in treatment time. Other factors, such as canine relationship at the beginning of treatment, bracket type (metal or ceramic), tooth extractions, age at start of treatment, severity of the initial malocclusion, sex and facial pattern had no significant bearing on treatment time. The duration of orthodontic treatment in adults, when performed by experienced orthodontists, is mainly influenced by factors related to patient compliance. However, several factors which were not included in this study may contribute to variability in orthodontic treatment time.

Lateral Talar Station

The sagittal relationship of the talus to the tibial shaft can prove invaluable to the orthopedist in understanding and effectively treating ankle pathologies such as ligamentous laxity and ankle arthritis. Any useful radiographic analysis tool to assess the lateral position of the talus must be employable reliably in the clinical setting. Previously published measurements to assess the lateral translational relationship of the talus relative to the tibial axis may not be available in the clinical setting or may be subject to significant inaccuracies. We have defined a sagittal talar position measurement (lateral talar station; LTS), which we postulated could be used reproducibly on clinical radiographs by the orthopedist to define the position of the talus as it relates to the anatomic tibial axis. In addition, we defined the normal range of the LTS measurement. A retrospective cohort of patients (121 ankles, 104 patients) who presented to our clinic with foot pain between 2005 and 2011 was evaluated for inclusion in the study. Exclusion criteria included patients with ankle trauma, instability, prior ankle surgery, or radiographic evidence of ankle osteoarthrosis. The final cohort consisted of 82 ankles. The LTS was measured digitally for each subject on weight-bearing lateral ankle radiographs by 3 observers. The mean LTS and standard deviation was determined for the entire cohort. In addition, as a means of validating our methodology, we performed an assessment of interobserver and intraobserver reliability in terms of the LTS measurements. The LTS measurements for the entire cohort fit a Gaussian distribution with a mean of 1.17 mm (SD = 0.9893 mm). Interobserver intraclass coefficients for 2 observers (medical student and radiologist) and intraobserver intraclass coefficients for 1 reader (orthopaedic surgeon) indicated excellent reliability, being above 0.9. The LTS was a reliable measure that could be used on weight-bearing lateral ankle radiographs to define sagittal position of the talus in a clinical setting. The normal distribution for the LTS was described in our study population. Level IV, case series.

Rendimiento de la evaluación cefalométrica para el diagnóstico sagital intermaxilar: Revisión narrativa

Sagittal intermaxillary anomalies are highly prevalent clinical entities that affect between 20% and 40% of the population. The origin of a high percentage of them relies on skeletal alterations of the jaws, which are characterized by the presence of an abnormal overjet. Their relevance becomes evident when their manifestations are severe, as they generate morphologic alterations that bring functional, aesthetic and psychological consequences both in children and adults. The quantitative evaluation of the sagital intermaxillary relationships is done preferably with cephalometry, through measurements that represent diagnostic indicators. There are numerous indices used for intermaxillary sagital classification, nevertheless, the information about their diagnostic value is limited, in terms of the sensibility and specificity associated with their use. The aim of the present narrative review is to analyze the performance of the cephalometric evaluation as a diagnostic tool for the measurement of the intermaxllary sagittal relationship in terms of sensibility and specificity. At present, no single cephalometric test assembles all the ideal characteristics to determine accurately if an individual presents a sagittal discrepancy. The available information related to the properties of specificity and sensitivity of the sagital intermaxillary cephalometric measurements as individual diagnostic indices is scarce. Among them, the ANB angle constitutes a suitable, simple and valid tool to determine these disharmonies. The use of cephalometric diagnostic tests for the sagittal intermaxillary evaluation in growing individuals must consider the dynamic nature of craniofacial development. Rev. Clin. Periodoncia Implantol. Rehabil. Oral Vol. 6(2); 96-101, 2013.

YEN-Linear: A sagittal cephalometric parameter

BackgroundThis research was designed to classify sagittal relationship by establishing a new cephalometric linear measurement, the YEN-Linear value. MethodsA total of 120 pretreatment lateral cephalograms were classified, based on Beta angle and YEN angle, into skeletal Class I, Class II, and Class III patterns. A new linear measurement, YEN-Linear, was based on the landmarks M (midpoint of anterior maxilla) and G (center at the bottom of symphysis) and a perpendicular from these points on the functional occlusal plane. Mean (SD) YEN-Linear values were calculated in all three groups of skeletal patterns. ResultsBased on demarcations determined using statistical analyses of the YEN-Linear values, patients with YEN-Linear values from −1 to 2.5 mm were considered as skeletal Class I; >2.5 mm, as Class II; and <−1 mm, as Class III. ConclusionsThe YEN-Linear measurement was developed for the assessment of the sagittal relationship between the maxilla and the mandible. Skeletal classification by YEN-Linear values was defined as follows: Class I, −1 to 2.5 mm; Class II, >2.5 mm; and Class III, <−1 mm.

Effects of maxillary protraction for early correction of class III malocclusion

This prospective study investigated the skeletal, dental, and soft-tissue effects of a mini maxillary protractor appliance in class III subjects with maxillary retrusion and mandibular protrusion and compared these changes with those of untreated, well matched control sample with normal occlusions. Twenty patients with class III malocclusion (mean age 11.1 ± 0.8 years) and 20 subjects with normal occlusion (mean age 10.9 ± 0.4 years) were included to this study. The class III subjects were treated with the mini maxillary protractor appliance, and the others were used as control subjects. Paired t-test and Student's t-test were used to determine the within- and between-group differences, respectively. In the study group, the maxilla moved forward (SNA, 2.0 degrees and A-Y, 2.4mm) (P < 0.001) with a slight rotation of palatal and occlusal planes (SN-PP, -0.8 degree and SN-OP, -0.7 degree) (P > 0.05). The mandible displaced backwards and downwards (SNB, -1.1 degrees; SND, -0.9 degree; B-Y, -0.9 mm and Pog-Y, -0.3mm; P < 0.001). These movements in the maxilla and mandible caused a significant improvement in intermaxillary sagittal relationship (ANB, 3.0 degrees; Convexity, 6.3 degrees; Wits, 4.6mm; P < 0.001). The maxillary incisors moved forward (2.2 degrees) while the mandibular ones backward (-1.9 degrees). The improvement in overjet was 5.0mm, and 66.1 per cent of this change (3.3mm) was skeletal (A-Y; 2.4mm and B-Y; -0.9 mm), and the remaining (1.7 mm) dentoalveolar (U1-NA; 0.9 mm and L1-NB; -0.8mm). The change in Ls-E measurement was more in the study group (2.1mm), and the difference between the groups was statistically significant (P < 0.001).

Geometric morphometric analysis of craniofacial variation, ontogeny and modularity in a cross-sectional sample of modern humans.

This investigation aimed to quantify craniofacial variation in a sample of modern humans. In all, 187 consecutive orthodontic patients were collected, of which 79 were male (mean age 13.3, SD 3.7, range 7.5-40.8) and 99 were female (mean age 12.3, SD 1.9, range 8.7-19.1). The male and female subgroups were tested for differences in mean shapes and ontogenetic trajectories, and shape variability was characterized using principal component analysis. The hypothesis of modularity was tested for six different modularity scenarios. The results showed that there were subtle but significant differences in the male and female Procrustes mean shapes. Males were significantly larger. Mild sexual ontogenetic allometric divergence was noted. Principal component analysis indicated that, of the four retained biologically interpretable components, the two most important sources of variability were (i) vertical shape variation (i.e. dolichofacial vs. brachyfacial growth patterns) and (ii) sagittal relationships (maxillary prognatism vs. mandibular retrognathism, and vice versa). The mandible and maxilla were found to constitute one module, independent of the skull base. Additionally, we were able to confirm the presence of an anterior and posterior craniofacial columnar module, separated by the pterygomaxillary plane, as proposed by Enlow. These modules can be further subdivided into four sub-modules, involving the posterior skull base, the ethmomaxillary complex, a pharyngeal module, and the anterior part of the jaws.

Eruption of the permanent maxillary canines in relation to mandibular second molar maturity

To evaluate the timing of spontaneous maxillary canine eruption in relation to stages of mandibular second molar maturation. Potential confounding effects from such factors as age, growth phase, and facial features were also explored. A sample of 106 healthy subjects (48 females and 58 males; age range, 9.4-14.3 years) with both permanent maxillary canines during the final phase of intraoral eruption were included. Mandibular second molar maturation (stages E to H) was assessed according to the method of Demirjian. Skeletal maturity was determined using the cervical vertebral maturational (CVM) method. Facial vertical and sagittal relationships were evaluated by recording the Sella-Nasion/mandibular plane (SN/MP) angle and the ANB angle. An ordered multiple logistic regression was run to evaluate adjusted correlation of each parameter with the mandibular second molar maturational stage. Overall, the prevalence of the different second molar maturational stages was 36.8%, 37.8%, and 27.4% for stages E, F and G, respectively. According to the regression model, this relation was not influenced by sex, CVM stage, SN/MP angle, and ANB angle. Irrespective of sex, growth phase, and facial features, the maturational stage of the mandibular second molar may be a reliable indicator for the timing of spontaneous eruption of the maxillary canine.

Growth modulation using functional appliances— Cephalometric predictors of successful response

The aim of this study was to determine any skeletal morphologic features evident on a pretreatment lateral cephalogram that may be used to predict improvement in the sagittal relationship during functional appliance therapy in Class II patients and compare changes between cases with and without a favorable response to growth modulation. Pretreatment and postfunctional lateral cephalograms were analyzed, and the change in the ANB angle was used to determine the skeletal response to treatment with a functional appliance. Based on the change in the ANB angle, the patients were divided into two groups of 12 patients each. Comparisons were made between the mean pretreatment (T1) cephalometric parameters of group I (skeletal) and group II (nonskeletal) to assess any pretreatment parameters that were significantly different between the groups. Changes due to functional appliance therapy from the pretreatment (T1) to postfunctional (T2) stage was measured as T2-T1 in both groups. The mean changes seen in group I and group II were then compared to assess the difference between changes brought about by growth modulation using functional appliances. Comparative statistical analysis of the data was done using one-way analysis of variance F test. This study showed that not all cases respond favorably to growth modulation. The pretreatment parameters that correlated to a favorable response were low mandibular plane angle, low basal plane angle, and a high Jarabak ratio. In those cases that responded favorably, the changes seen were an increase in Co-Go (ramus height), decrease in overjet, increase in SNB, and increase in the Jarabak ratio.

Different Non – Surgical Treatment Modalities for Class III Malocclusion

Class III malocclusions are usually growth-related discrepancies & are associated with deviation in the sagittal relationship of the maxilla and the mandible, characterized by a deficiency and/or a backward position of the maxilla, or by prognathism and/or forward position of the mandible or both. A class III malocclusion is defined by the presence of a class III molar and incisor relationship, which may range from a reduced overjet or edge-to-edge incisor relationship to a frank reversed overjet, the severity typically reflecting the underlying skeletal pattern. Treatment planning in class III cases is notoriously difficult and primarily influenced by the likelihood of future growth , skeletal discrepancy, size of the reverse overjet, extent of crowding, and degree of existing dento-alveolar compensation. An old orthodontic maxim states “the best time to treat a crossbite is the first time it is seen.” Thus, Class III malocclusion should be intercepted and treated at an early stage so as to prevent an orthodontic problem from progressing into severe dento-facial anomaly. So, early treatment of Class III malocclusion has been advocated to reduce the need of treatment in the permanent dentition, when camouflage orthodontic treatment or surgery become the only options. The clinician should determine whether the crossbite is skeletal or dental in origin from the profile analysis, cephalometric readings & intra oral findings. In this paper, the non-surgical orthodontic treatment of three patients with a Class III malocclusion is discussed and the use of compensation mechanics is illustrated. Though a series of treatment approaches can be found in the literature regarding treatment in Class III malocclusion. However, as with other types of malocclusion, there are really three main approaches to the correction of a class III malocclusion, i.e. growth modification, camouflage orthodontic treatment and surgical approach.

Evaluation of occlusal factors in patients with temporomandibular joint disorder

OBJECTIVE: The aim of this study was to determine the prevalence and the relation between the main occlusal factors and the temporomandibular disorder (TMD). METHODS: We analyzed 100 patients (50 diagnosed with TMD and 50 asymptomatic volunteers, control group) through a questionnaire that classified TMD as absent, mild, moderate and severe. Then, an evaluation was made of intraoral occlusal factors: Absence of posterior teeth, wear facets, overjet, overbite, open bite, posterior crossbite, sagittal relationship (Class I, II and III), centric relation discrepancy for maximum intercuspation, anterior guidance and balancing occlusal interference. The c² examined the association between TMD and considered occlusal variables. RESULTS: The prevalence of studied occlusal factors was higher in patients with moderate and severe TMD. Statistically significant results were found on: Absence of five or more posterior teeth, overbite and overjet greater than 5 mm, edge-to-edge bite, posterior crossbite, Class II and III, the absence of effective anterior guide and balancing side interferences. CONCLUSIONS: Indeed, it is concluded that there is a relationship between TMD and occlusal factors, however it can not be told to what extent these factors are predisposing, precipitating or perpetuating the disease. Therefore, despite its multifactorial etiology, one can not neglect the occlusal analysis of these patients.

Vertical facial pattern and sagittal relationship in patients with Class II malocclusion: Are they interrelated?

ObjectiveTo examine the extent to which vertical facial morphology and sagittal relationship determined by overjet, Wits appraisal, and ANB angle are interrelated in patients with skeletal and dental Class II malocclusion. Materials and MethodsLateral cephalograms and dental casts were obtained from 140 untreated patients (68 males and 72 females, between 8 and 11 years old) with skeletal and dental Class II malocclusion. Overjet was measured on study casts and sagittal skeletal parameters as well as vertical facial morphologic characteristics were analyzed on lateral cephalograms. Stepwise and simple linear regression analyses were used to determine the statistical significance of the relationships between the sagittal parameters and vertical facial morphologic characteristics. Male and female samples were evaluated separately. ResultsLinear regression identified associations between vertical facial characteristics and overjet (female R2 value, 0.55; male R2 value, 0.47). Associations between vertical facial characteristics and sagittal skeletal parameters were weaker: ANB (female R2 value, 0.32; male R2 value, 0.20) and Wits (female R2 value, 0. 17; male R2 value, 0.15). Simple linear regression identified statistically significant moderate associations between overjet and all vertical facial characteristics. The largest significant associations were found between overjet and palatal plane:gonial-menton (female R2 value, 0.47; male R2 value, 0.28). The associations were stronger in the female sample. ConclusionsSagittal relationship is associated with vertical facial morphologic characteristics and is a moderate predictor of vertical facial morphologic pattern. Approximately 50% of overjet variance, 25% of ANB variance, and 15% of Wits variance are explained by vertical facial morphology in patients with Class II malocclusion.

Post-orthodontic intra- and interarch changes at 1 year: A retrospective study assessing the impact of anterior fixed retention

The aim of this study is to evaluate intra- and interarch changes over the year following active treatment appliance removal, and to analyze the impact of anterior fixed retention on these changes. This study is based on casts taken at appliance removal (T1) and one year after removal (T2) in two groups of 15 privately-treated adolescent patients. One group received anterior fixed retention (G2), and the other did not (G1). We applied the seven criteria of the American Board of Orthodontics Objective Grading System: alignment (anterior/posterior), vertical positioning of the posterior marginal ridges, interproximal contacts, buccolingual inclination of the posterior teeth, posterior occlusal contacts, sagittal occlusal relationships, and overjet (anterior/posterior). G1 and G2 together showed significant improvement in occlusal contacts, interproximal contacts, marginal ridges, and maxillary posterior alignment, but also a deterioration in anterior alignment, anterior overjet, and sagittal occlusal relationships. However, significant differences were found between the two groups, notably in terms of anterior alignment, which deteriorated more in G1. The relapse observed in anterior overjet and sagittal relationships seems independent of the retention modality, whereas the deterioration in anterior alignment was specific to the group without fixed retention. At the same time, there were spontaneous adjustments in posterior occlusion, favorable to treatment stability.

The Association between Maxillomandibular Sagittal Relationship and Pharyngeal Airway Passage Dimensions

The Association between Maxillomandibular Sagittal Relationship and Pharyngeal Airway Passage Dimensions

Orthodontic intrusion : Conventional and mini-implant assisted intrusion mechanics

Orthodontic anterior intrusion for correcting deep bites often constitutes an integral part of orthodontic treatment in order to improve sagittal and vertical incisor relationships, in cases of pseudo-deep overbite, where the anteriors are supraerrupted true intrusion of the incisors is indicated and also in patients with gummy smiles and periodontal compromised teeth to correct the gingival line and restore the esthetics of smile. There are various treatment modalities for most of these clinical situations with conventional mechanics like the technique advocated by Rickets or Burstone. However the use of mini implants for intrusion has revolutionized orthodontic anchorage and biomechanics by making anchorage perfectly stable. This article addresses various conventional clinical intrusion mechanics and especially intrusion using mini-implants that have proven effective over the years for intrusion of maxillary anteriors.

Maxillomandibular Plane Angle Bisector (MM) Adjunctive to Occlusal Plane to evaluate Anteroposterior Measurement of Dental Base

This study was undertaken to analyze the clinical usefulness of the maxillomandibular bisector, its reproducibility, its validity and its relationship to the functional occlusal plane, the bisecting occlusal plane and the nature of its cant. Thirty pretreatment lateral cephalograms, each of adolescents (above 18 years of age) and children (10- 12 years), seeking orthodontic treatment were randomly selected and the Wits technique of anteroposterior measurement was used to compare A-B values measured to the new plane with those measured to the functional occlusal plane (FOP) and to the traditional or bisecting occlusal plane (BOP). Present study showed that MM bisector plane is more reproducible and valid reference plane, than the FOP and BOP. A new plane, geometrically derived from the dental base planes, has been tested as an occlusal plane substitute for the measurement of anteroposterior jaw relationships. It lies close to but at an angle and inferior to the traditional occlusal planes and is highly reproducible at all times. Maxillomandibular planes angle bisector may be a useful adjunct for the cephalometric assessment of sagittal relationship of the patient.

The variation of facial soft tissue thickness in Iraqi adult subjects with different skeletal classes (A comparative cephalometric study)

Background: The variation of facial soft tissue thickness is an important factor in facial reconstruction and superimposition methods in forensic dentistry as well as for orthodontist and plastic surgeons because they provide the basis for quantification and repeatability. The purpose of this study was to compare facial soft tissue thickness of Iraqi patients with different types of skeletal relations. Materials and method: Lateral cephalometric study was conducted on 60 adult Iraqi patients with normal vertical dimensions (diagnosed clinically and radiographically as SN-Mandibular Plane angle 28○-36○), aged 18-30 years, classified according to skeletal sagittal relationship using ANB angle into three groups (each group consist of 10 male and 10 female subjects): Class I group (ANB2-4○), Class II group (ANB>4○) and Class III group (ANB<2○). Cephalometric analysis of soft tissue thickness was achieved by 10linearmeasurements using AutoCAD program 2007. Results and Conclusions: This study showed that the facial soft tissue thickness measurements were significantly higher in male than in female in almost all measured midline landmarks, in comparing the three skeletal relation groups, Class III group show the highest readings when compared to Class I and Class II, Class II show the lowest results among the three groups (except for the labiomental fold area and pogonion area), while Class I group lies between the other two groups for all the measured values.

Programa de extrações seriadas: variáveis relacionadas com a extração de pré-molares

OBJETIVO: verificar o percentual de pacientes que necessitaram extração de dentes permanentes, pré-molares, dentre aqueles tratados com extração de dentes decíduos para correção do apinhamento primário na dentição mista, bem como analisar as possíveis variáveis relacionadas. MÉTODOS: a amostra foi composta por documentações ortodônticas de 70 pacientes na dentição permanente, cujo tratamento iniciou-se na dentição mista com planejamento de um programa de extrações seriadas (PES). Todos os prontuários foram analisados por um único examinador, no intuito de verificar se o PES havia sido cumprido com a extração de dentes permanentes ou se havia sido realizada apenas extração de dentes decíduos. Verificou-se a associação entre a extração de dentes permanentes e as variáveis padrão facial; relação sagital entre as arcadas dentárias; IMPA; proporção tamanho do segundo molar permanente inferior/espaço retromolar; mecânica de controle de espaço e discrepância de modelo (teste exato de Fisher para as variáveis categóricas e modelo de regressão logística para as variáveis numéricas). Os resultados foram considerados para p&lt;0,05. RESULTADOS: dos pacientes que haviam sido tratados com extração de dentes decíduos para a correção do apinhamento na dentição mista, 70% necessitaram de extração de dentes permanentes. A análise estatística não mostrou associação significativa entre as variáveis estudadas e a necessidade de extração de dentes permanentes, com exceção da variável discrepância de modelo. CONCLUSÃO: a discrepância de modelo representou a principal determinante de extração de pré-molares no PES.

Prevalência de má oclusão em crianças de 7 a 12 anos de idade

OBJETIVO: verificar a prevalência de más oclusões em 3.466 crianças com 7 a 12 anos de idade, matriculadas em escolas públicas nas cidades de Lins/SP e Promissão/SP. MÉTODOS: considerou-se a relação sagital entre as arcadas dentárias, a relação interarcadas no sentido transversal e a relação de incisivos nos sentidos vertical e horizontal. Na relação intra-arcada avaliou-se a prevalência de diastemas, apinhamentos e perdas dentárias. RESULTADOS: entre as más oclusões, 55,25% das crianças apresentaram uma relação molar de Classe I, seguida de 38% de Classe II e 6,75% de Classe III. Na relação de incisivos houve prevalência de mordida aberta em 17,65% dos casos, seguida de 13,28% para mordida profunda e 5,05% de mordida cruzada anterior. A mordida cruzada posterior foi encontrada em 13,3% das crianças. Na relação intra-arcada, 31,88% das crianças mostraram diastemas; 31,59%, apinhamento; e 4,65%, perdas dentárias.

Predictive value of molar bite force on Class II functional appliance treatment outcomes

Sagittal intermaxillary changes brought about by functional appliances show large inter-individual variation. One factor that may in part explain these differences is the masticatory musculature and its functional capacity. The aims of this study were to investigate changes in maximal molar bite force during functional appliance treatment and to assess the influence of pre-treatment maximal molar bite force on treatment outcomes with functional appliances used in Class II malocclusion children. Twenty-five children (17 males and 8 females), aged 9-13 years, with a Class II malocclusion and increased overjet were treated with functional appliances for 1-2 years. Dental casts, lateral cephalograms, maximal molar bite force, and finger force measurements were performed before (T1) and after (T2) treatment. These same measurements were also performed 1-2 years before treatment (T0); the intermediate period before starting treatment served as the control. Multiple regression analyses were used to determine possible correlations between initial maximal molar bite force and dental or cephalometric changes during treatment. Maximal molar bite force, which increased pre-treatment (T0-T1), decreased during functional appliance treatment (T1-T2). Children with a weaker T1 maximal molar bite force showed a larger overjet reduction, greater improvement in molar relationship, greater reduction in ANB angle, and greater augmentation in SNB angle from T1 to T2. Treatment of children with Class II malocclusions with functional appliances seems to lead to more favourable treatment outcomes in those with a weaker maximal molar bite force. This was observed both as regards improvements in dental sagittal relationships, namely overjet and molar Class, as well as skeletal changes due to a decrease in ANB and an increase in SNB angles.

Does Skeletal Facial Profile Influence Preoperative Motives and Postoperative Satisfaction? A Prospective Study of 66 Surgical-Orthodontic Patients

The aim of the present prospective study was to assess whether patients' pretreatment facial profile influenced their motives for wanting a change in their appearance. We also assessed whether their post-treatment facial profile influenced their overall satisfaction with surgical-orthodontic treatment, the perceived change in facial profile, and general appearance. Finally, we assessed whether their degree of satisfaction was influenced by the specific change in their facial profile. The gender differences in these variables were also analyzed. A total of 66 orthognathic surgery patients were examined. The skeletal facial profile was analyzed on the lateral head films. Using the sagittal relationship between the maxilla and mandible, all patients were classified into 1 of 9 facial profile types before and after treatment. The influence of the patients' appearance on their motives before treatment and their satisfaction after treatment were evaluated using questionnaires. The preoperative facial profile type had no influence on the strength of the appearance motives; however, men had stronger appearance motives than did women. Treatment was associated with a high degree of satisfaction with both the overall result of the treatment and the perceived change in profile and general appearance. Of those patients who obtained a relative prognathic mandibula after treatment, the men voiced more outspoken satisfaction with their general appearance than did the women. The overall treatment satisfaction was not related to any specific changes in the facial profile. Most of the patients expressed strong appearance motives before treatment and high degrees of satisfaction with the treatment afterward. The facial profile types had little influence on these parameters.