The case of a patient who had a significant Class II, division 2, malocclusion and experienced myofascial pain dysfunction is presented. The patient was a 22-year-old Japanese woman who complained of pain and fatigue 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 advancement by sagittal split ramus osteotomy, and trimming of the gonial angles. Postoperatively, her facial appearance and occlusion were good. Furthermore, the function of the temporomandibular joints was improved and the symptoms of myofascial pain and dysfunction disappeared.