Surgical Class II Correction with Invisalign

My goal was to achieve a functional bite and improve her facial profile by addressing the underlying lower jaw deficiency. Her crowding and excessive overjet were accompanied by a retrusive mandible and chin. I chose a surgical approach because moving the teeth alone would not provide the mandibular advancement needed to meet these goals. I used Invisalign to align both arches and decompensate the teeth in preparation for surgery. This positioned the teeth for the planned jaw correction rather than using dental movement to camouflage the skeletal discrepancy. A bilateral sagittal split osteotomy, or BSSO, was then used to advance the mandible and improve the relationship between the upper and lower jaws. The Bella Smile Surgical Appliance provided hooks for surgical fixation and elastics while allowing Invisalign to remain the primary orthodontic appliance. This allowed us to prepare for surgery and complete treatment without transitioning to full braces. After the initial surgical healing period, we removed the appliance and resumed Invisalign to refine the alignment and coordinate the final bite. This combined approach improved her profile, reduced the overjet, and achieved a Class I dental relationship. Her TMJ soreness also resolved during treatment, although symptom relief was an observed outcome rather than a guaranteed benefit of surgery.