Case Report Table 1. Pretreatment Cephalometric Measurements Variable Norm Pretreatment SNA (°) 82.0 80.0 SNB (°) 80.0 76.0 ANB (°) 2.0 4.0 FMA (FH-MP) (°) 25.0 28.0 SN-MP (°) 32.0 28.0 4.0 0.0 104.0 87.0 4.0 2.0 90.0 93.0 Upper lip-E line (mm) −4.0 −5.0 Lower lip-E line (mm) −2.0 −4.0 U1-NA (mm) U1-SN (°) Figure 3. Initial panoramic radiograph and lateral cephalogram good oral hygiene and no signs of recession (Figures 1 and 2). Her temporomandibular joints are within normal limits with no signs of pain. Radiographic Findings The pretreatment panoramic radiograph shows that both condyles appear symmetric and round. Sufficient alveolar bone support is present in both the maxillary and mandibular arches. Primary teeth A, C, H, and J are 38 present. The maxillary right second premolar is erupting mesially, and the distal roots of A and J are still present; both maxillary canines are impacted and are partially overlapping the roots of the maxillary central incisors, with more overlap noted on the maxillary left central incisor. All third molars are present and developing. From the lateral cephalogram, the patient presents mild skeletal Class II with deep L1-NB (mm) IMPA (L1-MP) (°) bite, characterized by a retrognathic mandible (ANB = 4°, SNB = 76°) and a hypodivergent mandibular plane angle (SN-MP = 28°). The maxillary incisors are retroclined (U1-SN = 87°), and the mandibular incisors are well positioned (L1-MP = 93°; Figure 3; Table 1). PCSO Bulletin Spring 2021