Correct the Skeletal Class III Malocclusion with Severe Dental Compensation and Lateral Open bite by Indirect use of Maxillary TADs

The case reports a young woman with skeletal Class III (ANB= −0.5°) who was successfully treated with camouflage orthodontics even she already had severe dental compensation. A nonsurgical approach was adopted because of patient and parental concerns regarding surgical risk. Bilateral maxillary temporary anchorage devices (TADs) were inserted at the infrazygomatic crest, and Class III elastics were used to connect the bilateral lower arch canines to the miniscrews during arch leveling. The treatment resulted in a Class I molar relationship and a +3.0 mm overbite and improved the skeletal Class III relationship (ANB =+2.0°); with notable success in lower arch dental compensation. Despite a slight increase in the mandibular plane angle, acceptable occlusion and an improved profile were achieved by using only two TADs. This case demonstrated that a combination of maxillary TADs and Class III elastics can facilitate the counterclockwise rotation of the occlusal plane and retraction of the lower arch in patients with mild to moderate skeletal Class III malocclusion, particularly those with an anterior open bite tendency.