Orthodontic and orthognathic management of Class II division 1 malocclusion with pre-surgical uprighting of impacted lower third molars

This case report details the orthodontic and orthognathic management of a 15-year-old female patient presenting with Class II division 1 malocclusion, mandibular retrognathia, congenital absence of the lower right second premolar (LR5), and impacted third lower molars. Treatment involved upper and lower fixed appliances, space redistribution, and molar uprighting to facilitate the eruption of impacted lower third molars. Following pre-surgical orthodontics, a bilateral sagittal split osteotomy was performed to advance the mandible and achieve skeletal and occlusal correction. The multidisciplinary approach successfully corrected the skeletal discrepancy, improved facial harmony and established a functional occlusion, highlighting the value of closely integrated orthodontic-surgical treatment in managing complex malocclusions. CPD/Clinical Relevance: A multidisciplinary approach is crucial for the effective management of Class II division 1 malocclusion with mandibular retrognathia, hypodontia, and impacted lower third molars, ensuring optimal skeletal correction, occlusal function, and aesthetic balance.