Orthodontic Camouflage of an Asymmetric Angle Class III Malocclusion in an Adult Patient: A Case Report with 10-Year Follow-Up

Abstract

Background: The management of Angle Class III malocclusion in adults is challenging, particularly when skeletal discrepancies are moderate and patients refuse surgical treatment. Orthodontic camouflage using extraction protocols may represent a valid alternative in carefully selected    cases. Case Presentation: This case report describes the orthodontic treatment of a 35-year-old woman presenting with an asymmetric Angle Class III malocclusion associated with maxillary protrusion, severe mandibular crowding, and a significant dental midline deviation. Cephalometric analysis revealed a Class I skeletal pattern with dentoalveolar compensation. An asymmetric premolar extraction protocol was selected, followed by fixed appliance therapy. Treatment was completed after 24 months, achieving correction of crowding, midline alignment, satisfactory facial esthetics, and stable occlusion. Results: Post-treatment records demonstrated improved facial harmony, normalized overjet and overbite, Class I occlusal relationships, and correction of dental compensations. Clinical and radiographic evaluations at a 10-year follow-up confirmed long-term stability of the results. Conclusion: Orthodontic camouflage with asymmetric premolar extraction can be an effective and stable treatment option for selected adult patients with Angle Class III malocclusion who are not candidates for, or refuse, surgical intervention.