| Summary: | Background: With the introduction of high-tech appliances, anchorage devices, and improved patient awareness of the risks associated with maxillofacial surgery, treating complex situations with orthodontic treatment has become more difficult in recent years. This study was conducted to demonstrate that orienting the occlusal plane, all the dental, skeletal, and soft tissue parameters, would be improved and to find which of these parameters could be correlated with the steepness of the occlusal plane. Materials and methods: This was a retrospective study including 40 cephalometric interpretations for patients who were planned for four-unit extractions (20 cephalometric radiographies before treatment and 20 after finishing the treatment). All were treated in the same orthodontic clinic with the same protocol using the McLaughlin–Bennett–Trevisi (MBT) prescription, with 22 slots and one-step retraction following four-unit extraction based on temporary anchorage devices (TADs). Results: There was no significant change in the canting of the occlusal plane, and it remained relatively stable from 6.31° to 7.55°, while all the soft tissue-related cephalometric measurements were reduced significantly, except the nasolabial angle, as the relation of the upper and lower lip to the esthetic line of Ricketts’ (E-Line) was reduced by 2.91 and 2.46°, respectively; furthermore, the angle of convexity was reduced from 10.92° to 9.79°. Besides, the upper incisor display was reduced by 0.38° Conclusions: Both the Frankfort mandibular angle and upper-incisor-to-Frankfort horizontal plane were significant parametric factors associated with profile change after extraction treatment having a positive 0.01-level Pearson association with occlusal plane steepness. Therefore, using the MBT prescription with TAD-based retraction is one of the favorable methods for the management of complex cases.
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