Non-extraction treatment of a thirteen-year-old boy with a Class III skeletal discrepancy and severe crowding in both the upper and lower dentitions.

A thirteen-year-old boy presented with a Class III skeletal tendency in association with severe crowding in both the upper and lower arches. Whilst there was not a frank posterior crossbite, it was felt that the upper arch was narrow and that the lower arch was similarly constricted. Taking this into account along with the fact that his upper lip was flat and the nasolabial angle obtuse, it was decided to pursue a non-extraction treatment, with the aim of providing by expansion an extra 16 mm of space in the upper arch and 8 mm in the lower arch to accommodate the full dentition, and with a view to extracting third molar teeth later. This proved to be successful, albeit over an extended period of time, with active treatment taking nearly three and a half years. A realistic alternative would have been to remove four bicuspid teeth and pursue an orthodontic/surgical approach to treatment. In retrospect, and with the benefit of reviewing his records without surgical intervention, the treatment plan decided upon has been well justified.