Non-surgical underbite and asymmetry: extraction orthodontics for missing tooth and crossbite, Clippy-C treatment period of 1 year and 11 months

Hello.

This is Apgujeong Orthodontic Clinic.

23.11~25.10

There are two treatment options for underbite, that is, skeletal Class III malocclusion.

One is to undergo double jaw surgery to aim for a more complete facial appearance, and the other is to pursue compromise treatment with orthodontics alone.

If a patient is reluctant to undergo double jaw surgery, treatment is sometimes carried out with orthodontics alone, while accepting a certain limit to the result.

Of course, if the underbite is very severe, there are also cases where it is better not even to attempt orthodontic treatment without double jaw surgery.

This is something that requires a precise diagnosis at an orthodontic clinic.

About two years ago, this patient visited for orthodontic treatment.

The upper and lower midlines are offset by about 2 mm, and there is also crowding of the canine.

Because of the underbite, the front teeth bite in reverse.

This is called a crossbite.

The patient knew that this was a skeletal underbite requiring double jaw surgery, but did not want to go that far.

There is no premolar at the blue arrow.

In other words, there is one missing tooth.

If the patient had not been missing one premolar, we might have considered non-extraction treatment, but to balance the already missing premolar, we planned to extract the remaining three premolars.

Because the number of teeth needs to be balanced, extraction is also performed in the upper jaw, but the treatment must continue with careful control so that the upper front teeth do not move backward into the extraction space.

The patient chose Clippy-C, and treatment began that same day.

24.09

To keep the upper front teeth from moving backward as much as possible while moving the lower front teeth backward as much as possible, two orthodontic mini-screws were placed in the lower jaw.

25.08

After about three months of detailed adjustments, treatment was finally completed in October 2025.

25.10

The midlines are aligned exactly.

It is a perfect Class I bite.

Now let’s look at the before-and-after comparison.

The total treatment period was 1 year and 11 months, just one month short of two years.

23.11~25.10

The upper and lower midlines that had been misaligned are now matched.

23.11~25.10

23.11~25.10

The crossbite, where the front teeth bit in reverse, has been resolved.

Now let’s look at the facial comparison.

23.11~25.10

23.11~25.10

Let’s live with confidence and smile.

23.11~25.10

23.11~25.10

As the lower lip moved backward, the lips became more harmonious.

As a result of precise control of the amount of posterior movement, despite extraction orthodontics, the chin does not look more prominent.

25.10

Over the course of nearly two years, root resorption is visible in about two upper front teeth.

Root parallelism is good.

Accordingly, the posterior movement of the lower lip is noticeable.

The result is very good.

I hope this post will be helpful for people considering double jaw surgery for an underbite.