Treatment of a patient with mandibular deviation and dentofacial various problems on alignment and multidirectional relationships

A 22-year-old female with a mandibular rightward deviation, facial asymmetry, lower dental midline rightward deviation, anterior open bite, anterior crossbite, posterior crossbite, Class III molar relationship, and severe crowding had surgical orthodontic treatment. Following extraction of the upper second premolars, lower right first premolar, left second premolar, and all four third molars, the upper and lower teeth were aligned and dental arch widths coordinated in the preoperative orthodontic treatment. The mandible was moved backward and rotated to the left with a bilateral sagittal split ramus osteotomy. Acceptable facial esthetics and occlusion were obtained. The improvements in facial appearance and the dental arches remained stable after 2 years and 11 months.