Occlusal plane alteration in orthognathic surgery

This article discusses correction of functional and esthetic deformities by surgically increasing or decreasing the occlusal plane angulation. Clockwise rotation, or increase of the occlusal plane angulation, is a well-accepted technique in orthognathic surgery. However, counterclockwise rotation (decrease of the occlusal plane angulation), has not been a well-accepted treatment approach. The functional and esthetic characteristics of the low occlusal plane and the high occlusal plane facial types are presented, specific surgical approaches to alteration of the occlusal plane are described, and the long-term stability of results with both clockwise and counterclockwise rotations of the occlusal plane are discussed. Cases illustrating the application of these surgical approaches are presented.