Skeletal classification of maxillary and mandibular malpositions.

Criteria used to establish ideal skeletal position of the maxilla and mandible relative to the cranial base is exacting. It must first enhance facial esthetics and facial profile. Secondly, it must improve TMJ health; and finally, it must improve physiologic harmony. Physiologic harmony include alleviation of many medical symptoms such as migraine headaches, neck-shoulder-back pain, myalgia, mouth breathing, otitis media, ringing in the ear, dizziness, vertigo, etc. The Skeletal Archial Analysis is a powerful diagnostic aid. Once the skeletal landmarks are learned, it takes clinicians less than 5 minutes to trace and diagnose. This is because it uses visual references rather than columns of angles and linear measurements. How powerful and accurate is this analysis? If done correctly, patients treated to their anterior arc and correct vertical arc will often times achieve significant facial esthetics, TMJ health, and physiologic harmony. Both the Skeletal Archial Analysis and the Skeletal Classification System indicate whether the disharmony is in the maxilla, mandible, or both. They clearly show in which direction these skeletal structures must be moved to enhance facial appearance and health. In all cases, the direction is to move these structures as close to skeletal Type I, Normal, as physiologically possible. Figure 8 shows a 21-year-old female individual with this skeletal classification. She has ideal maxillary and mandibular A-P position and ideal lower facial height. As can be seen, she has an attractive facial profile and she has no clinical symptoms of temporomandibular disorder or other medical problems. Conversely, patients with facial disharmony often seem to have various medical problems, including premenstrual syndrome and infertility. Once clinicians become adept at using the Skeletal Archial Analysis, they will begin to see many more types of facial disharmonies than previously thought. It then becomes a verbal challenge to accurately describe the multitude of different types of skeletal malpositions. In light of this, it is important that a universal Skeletal Classification System be established to promote better understanding in the diagnosis and treatment of facial-skeletal problems.