Orthodontics case study with skeletal class II division one malocclusion

Fig 1 pre-treatmentEmma Laing describes a case where she treated a skeletal class II division one malocclusion with a small retrusive mandible and chin.


The majority of patients I see for treatment have malocclusions we can treat well within the realms of conventional orthodontics, whether with fixed appliances or aligners.

A few patients will however have such a discrepancy in the positions of their skeletal bases that regular orthodontic treatment is insufficient, and a combination of jaw surgery (orthognathic surgery) and orthodontic treatment is required. It is my pleasure to present a case of such nature that is near to completion.

Here follows a succinct summary of the orthodontics case study. The surgeon was Miss Helen Witherow, a highly-experienced consultant in oral and maxillofacial surgery.

Presenting complaint

The patient presented having seen several clinicians over the years finding about various treatment options, so he was fully aware of his malocclusion and was now looking to proceed with treatment for a complete profile and dental correction, for both aesthetic and functional reasons such as being unable to breathe properly through his nose. As an engineering student he felt Orthodontics with surgery case study


The university holidays would be an appropriate time for recovery from any surgery. The patient is medically fit and well and blind in his left eye.

Examination and clinical diagnosis

He presented with a skeletal class II division one malocclusion with a small retrusive mandible and chin. The vertical dimension and MMPA were increased. The nose deviated to the right. His soft tissue profile was obtuse and the nasio-labial angle was obtuse. The lips were incompetent with increased incisor display at rest and the tongue was forwards at rest and on speaking and on forming an anterior oral…

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