Orthognathic surgery is the primary treatment option for severe skeletal discrepancy. However, orthodontic camouflage should be considered as an alternative treatment option considering benefits and risks of a surgery. A 19.5-year-old man presented with a severe prognathic mandible with a Class III molar relationship and an anterior crossbite. Orthognathic surgery could be considered due to his severe skeletal discrepancy and mandibular prognathism. However, the anesthetist for the orthognathic surgery did not recommend a surgery under general anesthesia due to risk factors such as bleeding and infections associated with the patient’s aplastic anemia. As a camouflage treatment, backward rotation of the mandible by orthodontic extrusion of the posterior teeth was planned. An anterior bite plate, intermaxillary elastics, and fixed orthodontic appliances were used to extrude the posterior teeth and to align the dentition. After 17 months of non-surgical orthodontic treatment, normal occlusion was achieved and facial profile was dramatically improved. This case report describes dentoskeletal and soft tissue effects of mandibular rotation with a long-term stability.

Keywords: Class III treatment, Soft tissue, Adult treatment, Aplastic anemia