RESUMEN
Surgery-first approach (SFA) has been a paradigm shift in the field of orthognathic surgery. Majority of the published cases that have been managed by this approach are of skeletal class III. This communication describes a patient of 18-year-old male diagnosed with skeletal class II malocclusion due to mandibular retognathism. He was managed with SFA and was using skeletal anchorage system to prevent postsurgical relapse. Bilateral saggital split ramus osteotomy was carried out to achieve the mandibular advancement of 7âmm. Using this approach good esthetic result, functional occlusion was achieved. Patients were benefited with marked improvement in profile at a very early stage of treatment and shorter total treatment time of about 7 months.