In three cases of c.c.d. it could be shown, that combined orthodontic and surgical treatment provided further possibilities for the treatment of severe problems in permanent dentitions as well as correcting extreme skeletal discrepancies of the facial skeleton in c.c.d. Well-scheduled removal of supernumerary teeth creates space for the spontaneous eruption of delayed teeth. By the use of carefully applied orthodontic forces, alignment of even extremely displaced teeth is shown to be possible. Furthermore, it is demonstrated that careful planning and realization of osteotomies in the midface can remarkably improve the facial appearance and the relationship of the jaws thus facilitating particularly future prosthodontic treatment.