The etiologies of Class III malocclusions may result from mandibular prognathism, maxilla deficiency, or both. For growing children with Class III malocclusions characterized with deficient maxilla, the treatment of choice would be protraction of the maxilla. Successful orthopedic treatment through growth modification has increased the possibility to correct developing Class III malocclusion with non-surgical method. In addition, maxillary expansion is frequently required in treatment of Class III malocclusions by increase the transverse width of the maxilla, and possibly enhance the protraction effect of the facemask through disrupting the maxillary suture system. Herein we report a case of 8-year-old boy presenting a concave profile, deficient midface, and Class III malocclusion with anterior crossbite. Severe space deficiency (10 mm) was noted for the upper arch. Moreover, his upper left central incisor was impacted with root dilaceration. Surgical exposure and orthodontic traction of the impacted incisor was performed by using partial fixed appliance and a palatal arch with extension arm. The Class III malocclusion was corrected after the treatment with a rapid palatal expander and a facemask followed by full-arch bonding to gain the space for alignment of second premolars. Class I canine and molar relationship was achieved, and the facial profile was improved. Close follow-up is required to monitor the mandibular growth and the long-term treatment outcome.

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Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.