Background: Class II skeletal malocclusions with maxillary protrusion in particular cases are an indication of maxillary push back. When a Le Fort I is performed with (or without) bilateral sagittal split for major class II deformities, the occlusal results are generally good. But the aesthetic results could be insufficient. The objective of that communication is to point out the deformities in which the maxillary push back is not suitable.

Methods: Ten cases of Le Fort I push back were performed. The analysis was done on an occlusal and aesthetic point of view. Indications were based on clinical evaluation and Delaire’s cephalometric analysis. The analysis was performed before and after the surgery at 6 months (post-op). The aesthetic result was appreciated by the patient and the orthodontist.

Results: Eight patients are considered to have good occlusal results and an improvement of the aesthetic situation. In two cases the occlusal result was stable but the aesthetic result despite a clear improvement have some drawback of the push back movement of the maxilla. These adverse cases clearly were found in cases of centro-facial protrusion. It is clear that this category of deformities asks for another way of treatment.

Conclusion: Ten patients affected by class II malocclusions were treated by Le Fort 1 push back osteotomies. It is clear that 8 of them got excellent results on aesthetic and occlusal points of view. The two insufficient results which presented centrofacial protrusion had adverses effects of the procedures leading to think about another way of treatment.

Key words : orthognatic surgery; angle class II malocclusion; Le Fort osteotomy; maxillofacial abnormalities