Treatment of a Class II deformity with skeletal open bite and lateroocclusion

A fundamentally important treatment outcome in orthognathic surgery is improved dentofacial esthetics in both the sagittal and vertical dimensions. In patients with a skeletal open bite, increased lower face height and a strained lip closure, the vertical dimension relationships can be improved by surgical impaction of the maxilla. The consequence of maxillary impaction is an autorotation of the mandible and the elevation of the tip of the nose as the anterior nasal spine is repositioned. Naturally, the skeletal and soft tissue responses are dependent on the extent of surgical repositioning. We present here a clinical case that demonstrates these changes.