Abstract
Treatment of mandibular asymmetry with skeletal open bite poses big challenge for orthodontists. Presence of macroglossia is another aggravating factor that makes open bite worse. Masticatory function is highly compromised in cases where anterior open bite extends to posterior regions. Treatment of mandibular asymmetry with complete anterior and posterior open bite with occlusal canting has not been described in the past. There are very few case reports which describe treatment of severe open bite with contact only in second molar regions. Bilateral Sagittal Split Osteotomy is preferred surgical option for most mandibular asymmetries but unilateral sagittal split osteotomy has been attempted by very few. This case report describes treatment of Asymmetric Skeletal Openbite with customised surgical procedure in combination with orthodontics. Here, anterior and posterior open bite was treated with Unilateral Sagittal Split Osteotomy (USSO), paramedian ostectomy and partial glossectomy. After the treatment, the patient's masticatory function was enhanced in addition to improvement in aesthetics.