Surgical-orthodontic treatment for skeletal class ii malocclusion with vertical maxillary excess, anterior open bite, and transverse maxillary deficiency

Nongrowing adult patients with skeletal open bite have been considered among the most difficult to treat. This case report describes the surgical-orthodontic treatment of a blind 20-year-old woman who presented with skeletal class II malocclusion with vertical maxillary excess, anterior open bite, and transverse maxillary deficiency. After the transverse maxillary deficiency was corrected with miniscrew-assisted rapid palatal expansion, Le Fort I osteotomy with anterior segmental osteotomy and bilateral sagittal split ramus osteotomy with advancement genioplasty were used to correct the vertical maxillary excess and the anterior open bite. The patient's facial appearance was markedly improved, and she achieved a functional and stable occlusion after these treatments. This case report demonstrates the efficiency of miniscrew-assisted rapid palatal expansion for a patient with transverse maxillary deficiency and the benefit of a team approach using effective orthodontic mechanics in orthognathic surgery to correct a severe dentofacial deformity.