Camouflage treatment of severe hyperdivergent Class Ⅲ malocclusion with clear aligners

A 41-year-old female presented with chief complaints of anterior crossbite and mandibular protrusion, along with an anterior open bite. She declined orthognathic surgery and fixed appliances and opted for orthodontic treatment with clear aligners. After assessment and consultation, we addressed her esthetic concerns by extracting the mandibular right central incisor and distalized the mandibular molars with the help of temporary skeletal anchorage devices. The gingival black triangles, which resulted from excessive anterior retraction, were reduced by reshaping the proximal surfaces of the adjacent teeth using flowable composite resin restorations. After 41 months of active treatment, the crossbite and open bite were successfully corrected. The facial profile associated with mandibular protrusion was improved.