Severe skeletal Class III malocclusion treated without surgery or extraction

Among the malocclusions involving skeletal discrepancies, Class III occurs with the least frequency; however, it is also severe in the majority of cases. Compared with a Class II malocclusion, the mesial occlusion invariably manifests itself with greater deforming characteristics of facial harmony. The deficiency in the middle third of the face and/or the excessive length of the lower third of the face leads to significant loss of the profile's harmony. Good treatment strategies for this type of malocclusion could involve anything from intervening in the mixed dentition and/or permanent dentition in young adults to the combined orthodontic and surgical approach in patients without growth potential, who do not allow for compensations. This case report illustrates a Class III adolescent patient with severe facial profile deformity during the pubescent growth spurt, treated without extractions or orthognathic surgery.