Case Report Option 2: Combination of orthodontic treatment with bimaxillary orthognathic surgery. Extract the maxillary and mandibular first premolars to reduce incisor proclination. After presurgical orthodontics, Le Fort I maxillary impaction, along with bilateral sagittal split osteotomy advancement and autorotation of the mandible should be performed. Figure 4. ABO Discrepancy Index (DI) score 52 PCSO Bulletin    Summer 2020