Facial balance and harmony: an attainable objective for the patient with a high mandibular plane angle.

Facial balance is an attainable goal of orthodontic treatment. If it is within the power of the orthodontist to favorably affect facial balance, doing so should be an overriding priority. The question, "What can be done to preserve or enhance facial balance, harmony, and proportion?" should be answered during diagnosis in any patient who presents for orthodontic treatment. The purpose of this paper is to offer some answers to this question when the patient has a medium to high Frankfort mandibular angle or, stated differently, a moderate to excessive anterior facial height. If facial balance is to be a reality for patients with these skeletal patterns, the following three objectives must be met during treatment: (1) The mandibular incisors must be upright or overly upright over their bony support. (2) Anterior facial height must be controlled. (3) Posterior vertical dimension must be controlled. If these three objectives are realized during active mechanotherapy of moderate- to high-angle patients, balance and harmony of the lower face should be an attainable goal.