Treatment of a severe Class III skeletal discrepancy at an appropriate age

The 13-year-old female patient presented for correction of a severe Class III malocclusion with a Class III skeletal pattern. This was considered an appropriate age for treatment as earlier treatment may have been subject to relapse because significant facial growth may have occurred after treatment, and because treatment at a later age may have required orthognathic surgery. Initially, maxillary expansion was provided to widen the maxilla and to free the circum-maxillary sutures. Maxillary protraction headgear was worn to perform sagittal skeletal improvement. Fixed orthodontic appliances were placed to align the dentition and Class III elastics were used to improve intercuspation and stability. Patient cooperation was crucial for success. The skeletal changes provided rewards that included significantly improved facial and dental appearance, while avoiding orthognathic surgery.