Figure 11

Age 13.7. Situation after surgical exposure and orthodontic extrusion of 34 and 44 with a removable appliance and before bonding of the fixed appliance. Extraorally: Hypertelorism and proptosis. The latter could be seen as a consequence of midfacial hypoplasia and retroposition of infraorbital rim. Trapezoidal shape of mouth, impossibility of lip closure at rest due to vertical excess of lower third of face. Intraorally: Class III with reclined lower incisors, anterior open bite, bilateral crossbite, and crowding in both arches. V-shaped maxillary arch with midline "pseudocleft" due to severe fibrous hyperplasia of lateral palatine ridges.