“Surgery First Approach” for Skeletal Class II Correction Combined With Temporary Anchorage Device.

“Surgery First Approach” (SFA) is a growing trend that provides an immediate facial change. The SFA protocol utilizes the dentoalveolar compensations as advantage to effect changes, which in conjunction with Regional Acceleratory Phenomenon enhances tooth movement thereby reducing total treatment duration. post-surgical orthodontic phase often complicated by rapid accelerated producing non-predictable nature of movements. With combined application temporary anchorage devices these movements are made predictable three dimensions. This case report illustrates skeletal Class II patient combination and TAD aided treatment. A 19-year-old female presented proclined upper anteriors retrusive lower jaw. Clinical examination revealed severe lip incompetency, mandibular deficiency, malocclusion, bimaxillary incisor proclination, severely crowded arch on low plane angle. involving BSSO advancement genioplasty was performed, followed TADs. time 14 months, following excellent change stable occlusion achieved. year follow up also presented.