Facial pattern I, II and III: what each one indicates
Quick facts
- Definition
- Classification of the face by the relationship between the maxilla and the mandible, assessed in facial analysis, especially in profile.
- Origin
- Brazilian orthodontics, popularized in the classification by Capelozza Filho.
- Categories
- Pattern I, Pattern II, Pattern III, Long Face and Short Face.
- Difference from Angle Class
- Angle Class describes the bite (dental relationship); the pattern describes the face and the skeleton.
- Relevance in HOF
- Helps separate what injectables can soften from what calls for orthodontic or surgical assessment.
Facial pattern is the classification of the face by the relationship between the maxilla and the mandible, made mainly by analyzing the facial profile. In the version most used in Brazil, from orthodontics, there are Pattern I (balanced bases), Pattern II (maxilla ahead of the mandible), Pattern III (mandible ahead of the maxilla) and the vertical patterns Long Face and Short Face. In orofacial harmonization (HOF), it helps decide how far chin and jawline filler makes sense.
What does each pattern indicate?
| Pattern | Relationship between the bases | Typical profile | What tends to show up |
|---|---|---|---|
| Pattern I | Balanced maxilla and mandible | Slightly convex | Concerns more about volume and contour than about the bony base |
| Pattern II | Maxilla ahead of the mandible (from maxillary excess or mandibular deficiency) | Convex | Recessed chin, retrogenia, marked labiomental fold, short-looking neck in profile |
| Pattern III | Mandible ahead of the maxilla (from maxillary deficiency or mandibular excess) | Straight or concave | Flattened midface, under-projected upper lip, projected chin |
| Long Face | Vertical excess of the lower third | Variable | Difficulty sealing the lips, gum exposure |
| Short Face | Vertical deficiency of the lower third | Variable | Short lower third, deep labiomental fold |
Facial pattern, Angle Class and biotype: what is the difference?
These are three ideas that overlap but are not the same:
- Angle Class (I, II, III): describes the bite, by the relationship between the first molars. It is dental.
- Facial pattern (I, II, III): describes the face, by the relationship between the bony bases seen in profile. It is skeletal and aesthetic.
- Facial biotype: describes the ratio between height and width and the direction of growth.
A person who wore braces may have the bite corrected (Class I) and still keep pattern II in the face, because the teeth were compensated over unbalanced bony bases.
Why does it matter in HOF?
- Recessed chin in Pattern II: chin filler can project the pogonion and soften the convexity, within limits. In large discrepancies, injectables only camouflage and the volume needed may leave the chin looking heavy. The assessment is covered in retrognathic profile.
- Pattern III: projecting the chin usually makes the appearance worse. The concern is generally in the midface, and the conversation about the nasolabial angle and the base of the nose gains weight.
- Shared indication: relevant skeletal discrepancies call for orthodontic assessment and sometimes orthognathic surgery. Referring is part of an honest indication.
How does it show up in the assessment?
- Profile at rest: convexity of the face, position of the lip and chin.
- Reference lines: the Ricketts E-line and the convexity angle help describe the profile, without replacing clinical judgment.
- Bite and orthodontic history: use of braces, extractions and surgeries.
Also known as: facial skeletal pattern, Capelozza classification, face pattern.
Frequently asked questions
What is facial pattern II?
It is a face in which the maxilla sits ahead of the mandible in profile, either because the maxilla is projected or because the mandible is retruded. The profile is usually convex and the chin looks recessed.
Is pattern II the same as Class II?
Not necessarily. Angle Class II is a relationship between the molars; pattern II is a relationship between the bony bases seen in the face. They often go together, but the bite may have been compensated with braces while the face keeps pattern II.