2Q2C. Sagittal

Correction of Sagittal problem

Just like the transverse problem, the most severe sagittal problem have skeletal or combined skeletal-dental origin.

Sagittal problems are often recognized by patients as overjet, upper teeth too far ahead of lower teeth or by reverse bite, lower teeth in front of the upper teeth. Among dental professionals, saggital problem that result in upper teeth too far forward of lower teeth are described as class II malocclusion and saggital problem that result in lower teeth to be in front of upper teeth is described as class III malocclusion.

Sagittal problem can be dental, skeletal, or combined dental/skeletal in origin. Additionally, the problem can be the teeth or bone of the upper jaw being too far forward or back, teeth or bone of the lower jaw being too far forward or back or combination of both.

Orthodontist must also consider the developmental stage of a child and how the child's natural growth and how manipulation of the child's natural growth may influence the sagittal relationship between the two jaw.

Finally, the orthodontist must also consider patient’s existing profile. For example, if patient have a excessively protrusive maxilla and a large nose, would the patient’s profile look better by brining the mandible forward? Or is it better to bring the maxilla back and have the patient undergo rhinoplasty with plastic surgeon?

As one can see, the proper diagnosis of the sagittal problem and deciding how to treat a sagittal problem can become fairly complicated.

Sagittal problem can be differentiated into the following category.

Dental class II

–upper teeth forward,

-lower teeth back

-Combination of two

Skeletal class II

Upper jaw forward

Lower jaw back

-combination of two

Dental class III

Upper teeth back

Lower teeth forward

Combination of two

Skeletal class III

Upper jaw back

Lower jaw forward

Combination of two

Additionally one can have any degree of combination of dental class II mixed with skeletal class II or dental class III mixed with skeletal class III.


Depending on the treatment technique and type of vertical and sagittal problems, sagittal problem may be resolved simultaneously with vertical problem or treated independently after vertical problem has been corrected. Regardless of independent correction or simultaneous correction, saggital problem would take 6 month to a year to correct.