Case Report Table 1. Pretreatment Cephalometric Measurements Variable Norm Pretreatment SNA (°) 82.0 77.4 SNB (°) 80.0 77.2 ANB (°) 2.0 0.2 Wits (mm) 0.0 −5.0 FMA (FH-MP) (°) 25.0 22.2 SN-MP (°) 32.0 33.6 4.0 3.2 104.0 92.5 4.0 1.7 90.0 86.9 Upper lip-E line (mm) −4.0 −8.8 Lower lip-E line (mm) −2.0 −7.9 U1-NA (mm) U1-SN (°) L1-NB (mm) IMPA (L1-MP) (°) Figure 3. Lateral cephalograms: pretreatment (left) and progress (18 months into treatment) Radiographic Findings Cephalometric analysis shows a skeletal Class I pattern (ANB = 0.2°) with retrognathic maxilla (SNA = 77.4°) and orthognathic mandible (SNB = 77.2°). Meanwhile, a Wits appraisal of −5.0 mm indicates a skeletal Class III pattern. The patient presents a normovergent facial type (SN-MP = 33.6°). Her mandibular incisors are retroclined (L1-NB = 1.7 mm; IMPA = 86.9°). Both of her upper and lower lips are retrusive to the E-line: the upper lip by 8.8 mm and the lower lip by 7.9 mm (Figure 3; Table 1). A panoramic radiograph generated from the initial cone-beam computed tomography (CBCT) shows all four third molars are developing but have not erupted yet. The sagittal sections of the bilateral temporomandibular joints of this initial CBCT scan show normal condyles with slight beaking and good cortication (Figure 4). The initial CBCT was taken without capturing all of the cervical vertebrae that need to be seen to evaluate her skeletal maturation. The progress lateral cephalogram at 18 months Winter 2021 PCSO Bulletin Figure 4. Pretreatment panoramic radiograph (top) and temporomandibular joint sections from the initial CBCT scan 41