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Case Reports in Dentistry
Volume 2018, Article ID 2495262, 9 pages
Case Report

Alteration of Occlusal Plane in Orthognathic Surgery: Clinical Features to Help Treatment Planning on Class III Patients

1Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas, 13414-903 Piracicaba, SP, Brazil
2Division of Dentistry, Faculty of Medical Science and Health – SUPREMA, 36033-003 Juiz de Fora, MG, Brazil
3Division of Dentistry, Faculty São Leolpoldo Mandic – SLM, 13045-755 Campinas, SP, Brazil
4Department of Oral and Maxillofacial Surgery, Pedro Ernesto University Hospital, State University of Rio de Janeiro, 20551-030 Rio de Janeiro, RJ, Brazil
5Department of Clinical Dentistry, Juiz de Fora Dental School, Federal University of Juiz de Fora, 36036-300 Juiz de Fora, MG, Brazil

Correspondence should be addressed to Daniel Amaral Alves Marlière; moc.liamg@ereilram.fmbtc

Received 31 December 2017; Revised 1 April 2018; Accepted 10 April 2018; Published 9 May 2018

Academic Editor: Daniel Torrés-Lagares

Copyright © 2018 Daniel Amaral Alves Marlière et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Dentofacial deformities (DFD) presenting mainly as Class III malocclusions that require orthognathic surgery as a part of definitive treatment. Class III patients can have obvious signs such as increasing the chin projection and chin throat length, nasolabial folds, reverse overjet, and lack of upper lip support. However, Class III patients can present different facial patterns depending on the angulation of occlusal plane (OP), and only bite correction does not always lead to the improvement of the facial esthetic. We described two Class III patients with different clinical features and inclination of OP and had undergone different treatment planning based on 6 clinical features: (I) facial type; (II) upper incisor display at rest; (III) dental and gingival display on smile; (IV) soft tissue support; (V) chin projection; and (VI) lower lip projection. These patients were submitted to orthognathic surgery with different treatment plannings: a clockwise rotation and counterclockwise rotation of OP according to their facial features. The clinical features and OP inclination helped to define treatment planning by clockwise and counterclockwise rotations of the maxillomandibular complex, and two patients undergone to bimaxillary orthognathic surgery showed harmonic outcomes and stables after 2 years of follow-up.