The case of a patient who had a significant Class II, division 2, malocclusion and experienced myofacial pain dysfunction is presented. The patient was a 22-year-old Japanese woman who complained of pain and fatique in her masticatory muscles. During presurgical orthodontic treatment, a one-tooth osteotomy was utilized to correct the lingual inclination of an ankylosed maxillary central incisor. The surgery consisted of intrusion of the anterior segment of the maxilla, intrusion of the anterior segment of the mandible, mandibular advencement by sagittal split ramuus osteotomy, and trimming of the gonial angles. Postoperatively, her facial appearence and occlusion were good. Furthermore, the function of the temporomandibular joints was improved and the symptoms of myofacial pain and dysfunction dissappeared.