Maxillomandibular relationships in patients with dentofacial deformities: diagnostic criteria utilizing three...

This paper evaluates the quantitative and qualitative diagnostic criteria utilizing three cephalometric assessments of the maxillomandibular relationship. Evaluation was applied to pretreatment and posttreatment cephalometric radiographs of 13 patients with dentofacial deformities that were corrected by combined orthodontic-surgical treatment with good esthetic and functional results. These evaluations were analyzed individually and compared to one another and with the type of surgery performed. Results indicate that (1) dentoskeletal discrepancy cases need evaluations in addition to conventional celphalometric analysis; (2) the evaluation based on SNA, SNB, and ANB angles is not reliable when there is an alteration in the lower one-third facial height; (3) the Wits appraisal shows good reading capacity but must be supplemented by additional analyses, because it does not differentiate the precise location origin of the deformities; (4) the McNamara analysis shows higher correlation between the actual surgical corrections performed, when the nasolabial angle is considered a primary guide to evaluate the position of the maxilla; and (5) notwithstanding the diagnostic capacity of the McNamara analysis, it has a definite tendency to present discrepancy values larger than would be inferred from the correction adopted by the surgeon, with the exception of mandibular advancement in cases of Class II with mandibular retrusion.