The term forward growth is widely misunderstood. Most people do not grasp the actual mechanical logic behind cranial and facial development.
What determines true maxillary forward position
The actual forward positioning of the maxilla is mostly determined by the cranial base angle. This structural angle literally pulls the upper maxillary attachments forward.
The key visual cue: deep set eyes
The most obvious external sign of genuine upper maxillary projection is deep set eyes. This is best observed from the side profile.
The twist: relative mandibular setback
Craniofacial mechanics create a paradox. Increased total and especially upper maxillary forward position puts the lower jaw in a relatively set back position.
- Forward projected upper jaw
- Relatively set back lower jaw
- Overall more convex facial profile
- Class II patients, deep bite, overjet
Why it does not look like classic forward growth
Because the lower jaw appears recessed next to the prominent upper jaw, the face does not match the classic image of a forward grown phenotype. The profile looks convex rather than straight or concave.
Misconception: equating forward growth with jaw alignment
Many people read forward growth as simply the upper jaw being in perfect alignment with lower jaw (=prominent chin automatically). This is incorrect too.
- True forward growth is not defined by mere anterior-posterior jaw relationship
- The apparent setback of the lower jaw may be only relative to an overly projected upper maxilla
- If the upper jaw is too far ahead of the lower jaw, *it does not look forward grown or attractive either*
Case study: class III pattern with flat maxilla
Consider the opposite visual presentation:
- Prominent lower jaw from the side
- Relatively flat maxilla
- Short midface and flat nose bridge
- Concave side profile
This is typical of class 3 patients. Even though the lower jaw is *relatively* forward, the maxilla looks sunk in, so definitely does not read as a forward grown face either.