Tratamiento ortodóncico-quirúrgico de paciente clase II división 1. Presentación de un caso clínico

The objective of this case report was to show the correction of a class II division 1 malocclusion in an adult patient. A female patient of 20 years of age attended the Orthodontics Clinic of the Division of Pos-Graduate Studies and Research of the Odontology Faculty at the National Autonomous University of Mexico. Her main reason for consultation was: «When I removed the wisdom teeth I was told that I could have orthognathic surgery but first I needed braces»; this in order to correct the dento-facial disharmony. Upon facial clinical examination, the patient presented a mesofacial biotype with competent lips; vertically she presented an increasedlower third. Her profile was convex with deficient chinprojection. Intraorally, the patient exhibited upper and lower crowding, molar and canineClass II, considerably increased overbite and overjet as well as noncoincident dental midlines. The cephalometric diagnosis showed a skeletal Class II due to maxillary protrusion. It was suggested an orthodontic-surgical treatment in three phases: pre-surgical, surgical and pos-surgical. In the pre-surgical phase the patient was decompensated in order to prepare her for surgery. During the surgical phase, mandibular sagittal osteotomies were performed to advance the mandible in combination with an advancement genioplasty. During the pos-surgical phase, ideal occlusal relationships were achieved in terms of canine classes, overbite, overjet, dental midlines and final detailing of the case. Through the treatment, the occlusion and facial harmony of the patient were improved.