Surgical orthodontics in the treatment of a class II, division 2 malocclusion: a case report.
1977
R. H., a 20-year-old man, had a severe Class II, Division 2 malocclusion. The bite was extremely deep, to the extent that the m,axillary central incisors were impinging on the mimosa in the depth of the vestibule. The deep-bite was complicated by the fact that an almost total buccal cross-bite existed, with occlusion only in the second molar region. Roth mandibular first molars were missing, and there was severe crowding in the mandibular incisor segment (Fig. 1). The patient’s appearance mirrored the severe dental problem. The lower face height was short, accompanied by a pronounced menton and an accentuated mental fold (Figs. 2, B and 3, B ) . The cephalometric findings were consistent with a Class II, Division 2 malocclusion. Both incisor segments were upright. The mandible was reasonably well positioned, and the mandibular plane ‘and the occlusal plane were relatively flat. The lower face height was short. The objectives of treatment were (1) to correct the dental discrepancy which was complicated by the extensive cross-bite and (2) to increase the lower face height and reduce the mental fold. Because of the facial appearance and the severity of the dental discrepancy, it seemed best to accomplish the major correction surgically. The selection of the proper procedure was based on the desire to accomplish three goals: (1) the (anteroposterior) dental discrepancy must be corrected, preferably without advancing pogonion any further. (2) The cross-bite
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