Surgical orthodontic management of skeletal class II malocclusion with vertical maxillary excess in an adult patient - A case report

This article discusses in detail the combined orthodontic and surgical treatment carried out for an adult female with skeletal Class II malocclusion with vertical maxillary excess. As the patient's chief complaint was gummy smile, along with orthodontic treatment for the correction of dental compensations, orthognathic surgery was elected as an option of treatment to correct the underlying skeletal Class II pattern due to vertical maxillary excess with improvement of facial profile. The treatment plan was carried out as: (1) Pre surgical orthodontics- levelling and aligning of the maxillary and mandibular arch with closure of lower first premolar extraction spaces. (2) Surgical phase-Lefort I osteotomy for superior maxillary impaction and anterior maxillary osteotomy set back (3) Post surgical orthodontics for finishing and detailing. The treatment duration was 24 months and restored significantly good facial esthetic with ideal occlusion, over jet and over bite. After 1 year of treatment, the results remained stable.