Non-extraction management of borderline class III malocclusion using miniscrew-assisted molar distalisation

Skeletal Class III malocclusion, or mesiocclusion, is characterised by maxillary deficiency, mandibular excess or both, resulting in a reversed or edge-to-edge incisor relationship. It often reflects underlying skeletal discrepancies in the maxillary or dentoalveolar components and may be worsened by functional mandibular shifts. Treatment options depend on severity and growth status, ranging from orthopaedic correction in growing patients to orthodontic camouflage or orthognathic surgery in adults. Accurate diagnosis and case selection are critical to ensure favourable outcomes.The introduction of temporary anchorage devices has expanded the scope of non-surgical management for Class III cases by allowing controlled distalisation of the mandibular dentition with minimal reciprocal effects and reduced reliance on patient compliance. Micro-implants placed in the infrazygomatic crest or buccal shelf regions provide stable anchorage for en masse distal movement without proclination of the anterior teeth.This case report presents the successful orthodontic management of a patient with bilateral Angle Class III molar relationship, an edge-to-edge bite, 0 mm overjet and reduced overbite, accompanied by mild skeletal discrepancy and a slightly concave facial profile. The patient declined orthognathic surgery and a non-extraction, camouflage approach was pursued. Using miniscrew anchorage, controlled en masse distalisation of the mandibular dentition was achieved, resulting in improved occlusion, facial balance and patient satisfaction.This case demonstrates that skeletal anchorage-assisted distalisation can serve as an effective, minimally invasive alternative for adult Class III patients unwilling to undergo surgical correction, achieving functional and aesthetic harmony through precise biomechanical control.