case_images: PMC11756205_01
case_images: Pretreatment facial and intraoral photographs
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case_images: PMC11756205_01_40001_2025_2298_Fig1_HTML.jpg
case_images: Fig1
case_images: Pretreatment facial photographs revealed a slightly concave profile, a protruded chin, and increased lower anterior facial height (Fig. 1).
case_images: Pretreatment dental casts
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case_images: Fig2
case_images: The intraoral examination and study casts (Fig. 2) exhibited Class III molar and canine relationships with anterior crossbites and severe crowding.
case_images: Pretreatment radiographs: A Lateral cephalogram. B Lateral cephalogram tracing. C Panoramic radiograph. D Cone-beam computed tomography image of both TMJs. L, left TMJ; R, right TMJ
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case_images: Fig3
case_images: Panoramic and cephalometric radiographs were obtained prior to the initiation of treatment (Fig. 3). Table 1. The evaluation of the temporomandibular joint (TMJ) (Fig. 3D) showed no signs of TMJ dysfunction, including pain, joint noise, limited jaw movement, or other related problems.
case_images: Treatment process: A at the 15th month of orthodontic treatment: retraction force was applied from mandibular canines to the temporary skeletal anchorage devices with segmented arch technic in mandibular dentition. B at the 21st month of orthodontic treatment: mandibular incisors were bonded with brackets and integrated into active alignment. C at the 27th month of orthodontic treatment: mandibular anterior teeth was retracted with sliding technique on 0.018 x 0.025-in stainless steel archwire
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case_images: Fig4
case_images: The overall duration of active treatment was 31 months (Fig. 4).
case_images: Post-treatment facial and intraoral photographs
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case_images: Fig5
case_images: Post-treatment intraoral examination (Fig. 5) and dental casts (Fig. 6) demonstrated that anterior crossbite was corrected, periodontal health was acquired, smile aesthetic was improved, the canine and molar relationships were aligned to achieve a Class I occlusion with proper overjet and overbite, the maxillary and mandibular dental midlines were aligned with the facial midline.
case_images: Posttreatment radiographs: A Lateral cephalogram. B Lateral cephalogram tracing. C Panoramic radiograph. D Cone-beam computed tomography image of both TMJs. L, left TMJ; R, right TMJ
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case_images: Fig7
case_images: The posttreatment panoramic radiograph revealed acceptable root parallelism in both arches, with no significant signs of root or bone resorption (Fig. 7C). Cephalometric analysis and superimposition (Figs. 7A, B and 8) indicated an improvement of sagittal skeletal discrepancy between maxilla and mandible (SNB, 85.1 ; ANB increased from - 0.4  to 0.1 ). As for TMJ, CBCT revealed no harmful consequences of bilateral condyle, and no TMJ pain or discomfort was reported during or after the orthodontic treatment (Fig. 7D).
case_images: Lateral cephalogram superimposition tracings
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case_images: Fig8
case_images: Cephalometric analysis and superimposition (Figs. 7A, B and 8) indicated an improvement of sagittal skeletal discrepancy between maxilla and mandible (SNB, 85.1 ; ANB increased from - 0.4  to 0.1 ). Furthermore, Lateral cephalogram superimposition showed no rotation of mandibular plane, which confirmed no rotation clockwise or counterclockwise of the mandible (Fig. 8).
case_images: CBCT: Comparison incisors area at pretreatment (A) and posttreatment (B)
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case_images: Fig9
case_images: In addition, the antero-posterior position of the maxillary incisors is basically unchanged, and the mandibular anterior teeth showed more lingual inclination (Fig. 9) (L1-NB, 6.9 ; IMPA, 71.8 ).
case_images: Follow-up facial and intraoral photographs after 2 years and 6 months of retention
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case_images: Fig10
case_images: Follow-up records of 2 years and 6 months are depicted in Fig. 10, showing that the occlusion remained stable.