Case Report Initial Lateral Cephalometric Measurements Variable Norm Pre-Treatment SNA (º) 82.0 83.6 SNB (º) 80.9 81.5 ANB (º) 1.6 2.1 FMA (FH-MP) (º) 24.3 27.4 SN-MP (º) 33.0 39.0 4.3 10.7 102.7 114.2 U1-NA (mm) U1-SN (º) L1-NB (mm) 4.0 11.6 IMPA (L1-MP) (º) 95.3 100.2 Upper Lip-E Line (mm) -5.1 4.2 Lower Lip-E Line (mm) -2.0 8.5 Treatment Options 1. Comprehensive orthodontic treatment in combination with orthognathic surgery: full fixed orthodontic appliances with extraction of all first premolars; one-piece Le Fort I orthognathic surgery for maxillary posterior impaction. 2. Comprehensive orthodontic treatment without orthognathic surgery: full fixed orthodontic appliances with extraction of all first premolars; low-hanging transpalatal arch (TPA); and vertical elastics. Post-treatment description of Case B.Q. begins on the next page. 34 PCSO Bulletin Fall 2017