Long-term skeletal stability following orthognathic surgery with counter-clockwise and clockwise rotation of the maxillo-mandibular complex: report of three cases

: The aim of the present study is to evaluate the long-term postoperative skeletal stability after orthognathic surgery with counter-clockwise rotation (CCWR) or with clockwise rotation (CWR) of the maxillo-mandibular complex. Three patients were submitted to orthognathic surgery associated with CCWR and CWR. Lateral cephalometric radiographs were obtained in centric relation for each patient, one day before surgery (T1), 1 week after surgery (T2) and 1 year after surgery (T3). Cephalometric angles analysed were: SN-OP, SN-A, SN-B, SN-Pg, and SN-Ar. Angular changes on occlusal plane (OP), condylar position, maxilar, mandibular, and pogonium prognathism were analysed. Maxilar, mandibular, and pogonium prognathism linear changes were also recorded in millimeters. Patients had no signs and symptoms of temporo-mandibular joints pathology. Patients 1 and 2 were submitted to orthognathic surgery with CCWR. Patient 1 presented an OP decrease on T2, from 6.37° to 4.01°. On T3, however, a 2.17° relapse was observed. Patient 2 presented an OP decrease on T2, from 8.14° to 3.45°. On T3, however, a 0.54° relapse was observed. Patient 3 was submitted to orthognathic surgery with CWR. It was observed an increase in OP angulation on T2, from 6.16° to 16.13°. On T3, however, it was observed a 7.57° relapse. Regarding OP stability following orthognathic surgery with CCWR and CWR, results of the present article are consistent with of some previous published studies. More cases should be followed and more research in this area are necessary to validate these approaches to avoid unsuccessful cases or to anticipate unwanted results. vertical maxillary hypoplasia; anteroposterior mandibular hypoplasia; high mandibular plane angulation; and Class I, Class II (most common), or Class III malocclusion with or without an anterior bite. HOP individuals may benefit from a MMC counterclockwise rotation (CCWR). LOP facial type presents some features: decreased OP angle (<4°); low mandibular plane angle; prominent mandibular gonial angles; strong chin relative to mandibular dental alveolus; and Class I, Class II, or occasionally Class III relationships. Individuals with LOP facial types may benefit from a MMC clockwise rotation (CWR). Maxillo-mandibular complex is routinely expressed by a triangle, which can be rotated in or counter-clockwise