Orthodontic Camouflage For Severe Skeletal Class Iii With Mandibular Retrusion.

This case report presents the successful orthodontic camouflage treatment of a low-angle adult patient with severe skeletal Class III malocclusion who refused orthognathic surgery. The study highlights the clinical outcomes achieved by establishing occlusion in the functional retruded position. A 22-year-old female presented with anterior crossbite (reverse overjet/overbite of 7-8mm), concave profile, and functional mandibular retrusion to an edge-to-edge incisor relationship. Cephalometric analysis showed SNA: 76.6°, SNB: 85.69° (initial)/81.53° (retruded), ANB: -9.08°(initial)/-4.85°(retruded), U1-SN: 111° (initial), IMPA: 84.35° (initial), FMA: 12.15° (initial)/18.87° (retruded). Diagnosis: skeletal Class III with low facial angle. Treatment plan: maxillary alignment without extraction, mandibular extraction of 34/44 for incisor retraction and crossbite correction. Treatment outcomes(23 months): complete Class III molar relationship, distal cusp-to-cusp canine occlusion, normal overjet/overbite (3mm), improved facial profile with reduced mandibular protrusion (SNB: 85.69°→84.29°), and mandibular clockwise rotation (FMA: 12.15°→18.87°) were achieved. Functional mandibular retrusion allowed orthodontic camouflage through differential mechanics. The clockwise rotation of the mandible helps correct crossbite and improve facial profile.Key considerations included controlling vertical dimension, incisor inclination, and avoiding dental compensations exceeding skeletal limits. For patients with low-angle severe skeletal Class III malocclusion accompanied by a functional retruded position of the mandible, conducting orthodontic camouflage treatment based on the position offers a non-surgical treatment alternative.