Aims: Few orthodontists or oral surgeons are using distraction osteogenesis techniques in their clinical practice. Instead, osteodistraction is primarily being used to correct severe maxillomandibular deformities commonly seen in syndromic patients. This technique has the potential, however, to achieve high-quality results in the traditional orthognathic-orthodontic patient with a less severe deformity. This report demonstrates the possibility of achieving an ideal functional occlusion with enhanced facial esthetics via the technique of gradual osteodistraction. Methods: Using a skeletal Class II mandibular deficient patient as an example, this report illustrates our methods of distraction treatment planning, surgical technique, distraction protocol, and orthodontic finishing. Results: Ideal facial esthetics with a bilateral, mutually protected occlusion, and a healthy periodontium were obtained. Important considerations when performing osteodistraction versus traditional orthognathic surgery included the direction of movement, neurosensory issues, stability/relapse potential, and clinical management. Conclusion: This report demonstrates the feasibility of applying distraction in a more traditional surgical-orthodontic patient population. Although the learning curve may initially be steep, this technique may provide the orthodontist, who will finish the occlusion after distraction is complete, with more control over the final position of the mandible. Moreover, the results should be more consistent, since the final mandibular position will be determined with the patient sitting in a chair, with little or no swelling, and comfortable enough to undergo mandibular manipulation. World J Orthod 2000;1:79–97.