Certain oral procedures require a sedated patient who is responsive to allow for the mouth opening and position change. Dexmedetomidine is a relatively selective alpha2-adrenoceptor agonist with sedative, analgesic, amnestic, and anesthetic-sparing effects. Large dose dexmedetomidine is suitable as a single agent for sedation and anxiolysis for plate removal in a patient with bilateral sagittal split osteotomy and Lefort 1 osteotomy with genioplasty.