Surgical Management of Skeletal Class II Facial Asymmetry with Decreased Lower Facial Height: A Case Report

In this article, we report the successful treatment of a patient, aged 30years, who had a skeletal class II facial asymmetry with decreased lower facial height and skeletal deep bite. A combination of Lefort-1 osteotomy for differential maxillary impaction and BSSO, subapical osteotomies for mandibular advancement was done. After 12 months of pre-surgical orthodontic treatment, Lefort-1 osteotomy for differential maxillary impaction and BSSO, sub-apical osteotomy was done for maxilla and mandible respectively. The Maxilla was impacted by 5mm and Mandibular advancement was done by 10mm. The total active treatment was 18 months.  Both occlusion and facial appearance were significantly improved by Surgical-Orthodontic treatment. Occlusion was stable after a year of retention.  There were no functional problems during or after treatment.  Our results suggest that Lefort I Osteotomy for differential maxillary impaction combined with BSSO, sub-apical osteotomy of the mandible in a Patient with skeletal class II facial asymmetry might be useful to improve occlusion and facial esthetics.