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Mod 5, case #1
Since this patient is lacking enough maxillary incisal display, would you include in your treatment objective to increase incisal display?
and if yes, would they way do it be through clockwise rotation of occlusal plane and extrude U anteriors would downgraft anterior maxilla as a surgical objective?
Thank you
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3 Replies
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Shadi –
Love your focus on the max incisor! Yes more display is needed for him. All three options – rotation, extrusion and downgraft
Another thing is with a downgraft you’ll get a slight Maxilla advance automatically. The general rule my OMFS team uses is for every 3mm of maxillary advancement it increases incisal display by 1mm (without changing anything else vertically)
Good work
-Chad Carter
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Thank you for your reply
Would clockwise rotation of the occlusal plane be automatically achieved with the anterior downgraft of maxilla? or is that something that must be done dentally after the surgery with extrusion of anterior teeth?
Thanks so much
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Shadi,
You are correct, when doing a surgical movement you are rotating the occlusal plane as a skeletal movement by the surgeons.
It is important in 2 plane occlusions or in a situation where you WANT a occlusal plane rotation that you don’t introduce. the compensations pre-surgically. In pre-surgical orthodontics we only seek to decompensate or as I tell patients “Place teeth squarely in the bone” and then “let the surgeon’s move the bone”
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