Severe Anterior Open Bite Corrected Primarily by Repositioning the Mandible.

The treatment procedure of a girl with skeletal class III malocclusion, severe anterior open bite, and transverse maxillary hypoplasia was reported. Extraoral examination revealed a disproportionately longer mid-face, rendering it unsuitable for clockwise rotation of the maxillary. Mandibular counterclockwise rotation by bilateral sagittal split ramus osteotomy, combined with segmental Le Fort I osteotomy aimed at widening the maxillary arch, was performed. As a result, skeletal class III malocclusion with severe anterior open bite was effectively corrected, and esthetic profile and functional occlusion were also achieved. The outcome remained stable 1 year postoperatively, without any significant signs of vertical recurrence. The osteotomy performed on the posterior part of the distal segment of the mandible during bilateral sagittal split ramus osteotomy was considered crucial for correction and prevention of recurrence.