Nonsurgical treatment of a patient with a Class III malocclusion

A patient with a bilateral Class III molar relationship came to the Department of Orthodontics clinic at Case Western Reserve University. Our first choice for treatment was a combination of orthodontic therapy and orthognathic surgery. The patient, however, opted for a nonsurgical approach that took 34 months and involved the extraction of 4 first premolars and a remaining deciduous tooth, and Class III vertical elastics. Although orthodontic treatment was considered to be a second-line alternative, the results suggest that, for some surgical patients, orthodontic treatment alone might be a better choice because of the favorable cost/benefit ratio.