title: Limitations in the surgical treatment of skeletal Class II deep bite malocclusions.
abstract: The present article illustrates a treatment option for managing the skeletal Class II malocclusion complicated by a deep bite and short face in an adult and emphasizes the limitations of such an approach and its potential complications. The patient had an inadequate tooth display upon smiling and a deep lower curve of Spee. Treatment consisted of a double jaw surgery with a maxillary three-piece LeFort to expand, downgraft, and advance the maxilla and a bilateral sagittal split osteotomy to advance the mandible. Treatment was staged so that the leveling of the mandibular arch was completed postsurgically by extrusion of the mandibular buccal segments. During surgery, the mandible was rotated clockwise at the osteotomy site to bring the chin down. This treatment approach resulted in a dramatic increase in the lower facial height, as well as an improvement in skeletal and occlusal relationships, with a much improved tooth display upon smiling, despite the few complications that occurred.
authors.affiliation: Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Laeticia
authors.initials: L
authors.lastname: Nassif
authors.forename: Patrick
authors.initials: P
authors.lastname: Anhoury
authors.forename: Naji Abou
authors.initials: NA
authors.lastname: Chebel
mesh_terms: D000328:Adult; D002508:Cephalometry / Q000379:methods; D002680:Chin / Q000473:pathology; D003724:Dental Arch / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008312:Malocclusion, Angle Class II / Q000601:surgery*; D008334:Mandible / Q000601:surgery; D019186:Mandibular Advancement / Q000379:methods; D008437:Maxilla / Q000601:surgery; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D019340:Osteotomy, Le Fort / Q000379:methods; D059229:Osteotomy, Sagittal Split Ramus / Q000379:methods; D057887:Overbite / Q000601:surgery*; D010347:Patient Care Planning; D063173:Retrognathia / Q000601:surgery; D012399:Rotation; D012904:Smiling; D014087:Tooth Movement Techniques / Q000379:methods; D016896:Treatment Outcome; D014716:Vertical Dimension