PEARLS

Fig. 1 Case 1. Pretreatment records.

Fig. 2 Cephalometric prediction tracing for mandibular advancement. A. Tracing of structures which will not be altered with surgery or orthodontics. B. Placement of distal mandible into optimum relation with remainder of skeleton. C. Addition of new A-Po line and corpus axis. D. Ideal placement of upper and lower incisors calculated position of molars and lips traced. E. Superimposed original and prediction tracing to evaluate overall treatment objectives and results.

Fig. 3 Case 2. Pretreatment records.

Fig. 4 Cephalometric prediction tracing for maxillary superior repositioning. A. Tracing of structures which will not be altered with surgery or orthodontics. B. Line parallel to the Frankfort horizontal at desired vertical level of maxillary central incisors. C. Autorotation of mandible around condyle as it will occur with the proposed amount of superior repositioning of the maxilla. D. Having added the proposed amount of genioplasty, a new A-Po line is drawn to the new Po as determined by the genioplasty. E. Placement of teeth as described.

Fig. 4a (Continued) F. Tracing of new nasal profile. G. Tracing of new upper lip position. H. Tracing of new lower lip position. I. Tracing of new soft-tissue chin. J. Superimposed original cephalometric tracing and prediction tracing.

Fig. 5 Cephalometric criteria which may be us d to help determine optimum anteroposterior soft-tissue chin position.

Fig. 6 Case 3. Pretreatment records.

Fig. 7 Cephalometric prediction tracing for combined maxillary and mandibular cases. A. Tracing of structures which will not be altered with surgery or orthodontics. B. Vertical referent parallel to Frankfort horizontal to determine new upper incisor position. C. Determination of anteroposterior position of maxilla and upper teeth. D. Placement of mandible into optimum position wlth maxilla. E. Finished prediction tracing. F. Superimposed original cephalometric tracing and prediction tracing.

Fig. 8 Utilizing the prediction tracing. A. Desired orthodontic change in the mandible. B. Desired orthodontic change in the maxilla. C. Desired position of the teeth prior to surgery to allow desired anteroposterior change at surgery. D. Superimposition showing desired orthodontic change following surgery.