An 18-year-old male patient presented for orthodontic retreatment with the chief complaint of unaesthetic facial appearance (Figs 1-  4). Previous treatment lasted 24 months and afterwards a retention period of 19 months. During clinical evaluation, a strongly concave profile with accentuated mandibular prognathism and lip incompetence was observed. A severe Class III molar relationship was present, combined with a substantial anterior crossbite (overjet -11 mm) and an excessive retroclination of the mandibular incisors. The mandibular first premolars were extracted during the previous orthodontic treatment, and at this point, 3-mm and 2-mm spaces were present in the right and left extraction sites, respectively. The cephalometric analysis indicated a skeletal Class III pattern due to mandibular prognathism (ANB = -11.5o, SNA = 84.3o, SNB = 95.8o). A substantial retroclination of the mandibular incisors (IMPA = 59o) and a vertical pattern, within the normal parameters (FMA = 24.8o) were also observed (Table 1). Additionally, a transverse asymmetry due to combination of a rotation of the maxilla (2 mm to the right) and the mandible (2 mm to the left) was found.
In the panoramic radiograph, signs of root resorption were observed in the maxillary incisors, and a mild horizontal bone loss was detected in the mandibular incisors. 
In order to correct the problems identified in this patient, the following objectives were set: buccal movement of the mandibular incisors, to achieve proper uprighting; mandibular setback combined with the advancement and impaction of the maxilla, to improve facial esthetics, achieve dental correction, and enhance incisor display in the smile. Lastly, mandible and maxilla alignment, to correct dental and facial midlines.