Orthodontic-surgical treatment of a class II division 1 patient. Case report

Abstract

The objective of this case report was to show the correction of a class II division 1 malocclusion in an adult patient. A female patient of 20 years of age attended the Orthodontics Clinic of the Division of Postgraduate Studies and Research of the Odontology Faculty at the National Autonomous University of Mexico. Her main reason for consultation was: «When I removed the wisdom teeth I was told that I could have orthognathic surgery but fi rst I needed braces»; this in order to correct the dentofacial disharmony. Upon facial clinical examination, the patient presented a mesofacial biotype with competent lips; vertically she presented an increased lower third. Her profile was convex with deficient chin projection. Intraorally, the patient exhibited upper and lower crowding, molar and canine class II, considerably increased overbite and overjet as well as noncoincident dental midlines. The cephalometric diagnosis showed a skeletal class II due to maxillary protrusion. It was suggested an orthodontic-surgical treatment in three phases: presurgical, surgical and postsurgical. In the presurgical phase the patient was decompensated in order to prepare her for surgery. During the surgical phase, mandibular sagittal osteotomies were performed to advance the mandible in combination with an advancement genioplasty. During the post-surgical phase, ideal occlusal relationships were achieved in terms of canine classes, overbite, overjet, dental midlines and fi nal detailing of the case. Through the treatment, the occlusion and facial harmony of the patient were improved.