Developing skeletal Class III malocclusion treated nonsurgically with a combination of a protraction facemask and a multiloop edgewise archwire

For a girl, aged 12 years 3 months, with a skeletal Class III malocclusion, negative overjet, severe maxillary crowding, and hyperdivergent pattern, orthognathic surgery combined with orthodontic treatment is often the treatment of choice, because it can greatly improve the patient’s facial profile and ensure the long-term stability of the results. However, because of high risks and treatment expenses, patients sometimes refuse to have surgery. We report a nonsurgical combination therapy including facemask and multiloop edgewise archwires and the outcome for a patient with a developing skeletal Class III malocclusion and a long anterior facial height. Treatment included advancement of the maxilla by orthopedic means and counterclockwise rotation of the mandibular occlusal plane by the orthodontic dentoalveolar compensation of distal en-masse movement of the mandibular dentition.