div epub:type=”chapter” role=”doc-chapter”>
J.-W. Choi, J. Y. LeeThe Surgery-First Orthognathic Approachhttps://doi.org/10.1007/978-981-15-7541-9_16
16. Occlusal Plane-Altering Orthognathic Surgery (Jaw Rotational Orthognathic Surgery)
Occlusal planeOcclusal plane alteratingOrthognathic surgeryJaw rotationClock wise rotationCounter clock wise rotationANSPNS
16.1 Concept of Occlusal Plane-Altering Orthognathic Surgery

Facial profiles. Based on the occlusion, the facial lateral profiles could be categorized like this

Traditional Class III orthognathic surgery based on the maxillary advancement and mandibular setback. The occlusal plane does not change in this approach

The facial profile could be dramatically different according to the occlusal plane angle although the patients have the same occlusion. This figure shows us the impact of the occlusal plane angle onto the facial profiles
Most Asian patients have varying degrees of dentoalveolar protrusion, making the Asian face look different from the Caucasian face. In these patients, maxillary advancement procedures may aggravate the dentoalveolar protrusion or widen the alar base, both of which are critically harmful for the aesthetics of the Asian face. Moreover, most Asian females have flat occlusal planes and prominent mandibular angles that cause the square appearance of the Asian face.

A Proffit and White’s discrepancy diagram of the maxillary (a) and mandibular dentition (b) with envelopes that represent the amount of dental repositioning possible using orthodontic movement, alone (yellow), orthodontic movement with growth modification (green), and orthodontic movement with orthognathic surgery (blue). Note that the envelopes are not symmetric and that, for example, orthodontic movement in the growing child is more effective in patients with mandibular deficiencies than in those with mandibular excesses

Occlusal plane-altering orthognathic surgery is related to the pitch, roll movement of the maxillomandibular complex. There are four ways to change the occlusal plane in orthognathic surgery using the pitch movement. It could be called as a jaw rotational orthognathic surgery


The anterior facial height (ANS-Pog = 66.5 mm) is longer than the maxillary length (ANS-PNS = 47.6). Because the horizontal leg(B1) is shorter than the vertical leg(A1) of the triangle, small changes(b1) will be accentuated (a1), leading to a gearing effect as Dr. Reyneke mentioned in his book
16.2 Classification Of Occlusal Plane Altering Orthognathic Surgery
-
1.
Clockwise rotation based on posterior nasal spine (PNS) impaction.
-
2.
Clockwise rotation based on anterior nasal spine (ANS) lengthening.
-
3.
Counterclockwise rotation based on PNS lengthening.
-
4.
Counterclockwise rotation based on ANS impaction.
-
1.
Clockwise rotation based on PNS impaction.
-
2.
Clockwise rotation based on ANS lengthening.
Stay updated, free dental videos. Join our Telegram channel
VIDEdental - Online dental courses