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Abstract

A case report is presented with a 32-year-old female patient who had received bilateral posterior segmental ostectomy of maxilla to create inter-occlusal space for mandibular removable partial denture 4 years before orthodontic first visit. She came for treatment with a chief complaint of maxillary protrusion. The patient presented skeletal Class II malocclusion with maxillary anterior vertical excess, occlusal plane cant with severe vertical discrepancy of maxillary arch , multiple missing teeth, as well as ill-fitted fixed partial dentures. For correcting of facial esthetics and severe skeletal discrepancies, the patient underwent surgical orthodontics with maxillary Le Fort I 3-pieces ostectomy, mandibular sagittal split osteotomy and genioplasty. The facial esthetic and skeletal discrepancies were improved after treatment, however the correction of occlusal plane cant was limited. The principle in surgery-first orthognathic approach and the intermaxillary fixation patient with complicated dental condition and jaw relation was discussed.

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