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Case Reports in Dentistry
Volume 2013, Article ID 397809, 6 pages
Case Report

Surgical Orthodontic Treatment of Severe Skeletal Class II

1Orthodontic Division, Department of Preventive Dental Sciences, Faculty of Dentistry, King Abdul-Aziz University, Jeddah, Saudi Arabia
2Oral and Maxillofacial Surgery Department, Faculty of Dentistry, King Abdul-Aziz University, Jeddah, Saudi Arabia

Received 13 January 2013; Accepted 20 February 2013

Academic Editors: I. Anic and G. Gómez-Moreno

Copyright © 2013 Fahad F. Alsulaimani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


This paper describes an adult Saudi male patient who presented with a severe skeletal class II deformity. The case was managed with a combination of presurgical orthodontic treatment followed by a double jaw orthognathic surgery and then another phase of orthodontic treatment for final occlusal detailing. Extraction of the four first premolars was done during the presurgical orthodontic phase of treatment to decompensate upper and lower incisors and to give room for surgical setback of the maxillary anterior segment. Double jaw surgery was performed: bilateral sagittal split ramus osteotomy for 8 mm mandibular advancement combined with three-piece Le Fort I maxillary osteotomy, 6 mm setback of the anterior segment, 8 mm impaction of the maxilla, and 5 mm advancement genioplasty. Although the anteroposterior discrepancy and the facial convexity were so severe, highly acceptable results were obtained, both esthetically as well as occlusally.