Class II subdivision malocclusions can be corrected through a variety of treatment protocols, depending on the etiological factor which produces the asymmetric dentoalveolar characteristics of the malocclusion.

    However, when there is also a severe skeletal component associated with the malocclusion, such as a vertical growth pattern and a retruded mandible, a combined surgical approach would be the best treatment option. Therefore, the purpose of this article is to describe the combined surgical/orthodontic diagnosis and treatment of a Class II subdivision malocclusion with these characteristics and discuss the pros and cons of this approach.