Abstract: Objective: This case report described the orthodontic camouflage treatment of a severe skeletal Class III malocclusion with asymmetry in a teenager using miniscrew assisted maxillary skeletal expander (MSE) and maxillary protraction with a facemask, along with micro-implant assisted mandibular full-arch distalization. Diagnosis and Treatment: The patient refused combined orthodontic-orthognathic treatment, leading to the decision to proceed with orthodontic camouflage treatment. The MSE was utilized to address the transverse deficiency of the maxilla, correct buccal tilting of the posterior teeth, and establish posterior occlusal coverage. Facemask protraction was used to promote maxillary development, meanwhile leading to posterior and downward rotation of the mandible. Micro-implant anchorage was employed to distalize the mandibular dentition, correct the crossbite and midline, and establish proper occlusion. Results: Post-treatment, the patient achieved Class I canine and molar relationships, with the upper and lower midlines nearly coinciding. The root parallelism was good, and both the patient and their family were satisfied with the treatment outcome. Conclusions: By strictly adhering to the indications of camouflage treatment, it is possible to correct maxillary transverse and sagittal deficiencies through arch expansion and forward traction, while retracting the mandibular dentition to resolve the crossbite, thereby establishing a neutral molar relationship. This approach improves both function and aesthetics for the patient, with confirmed clinical effectiveness.

Key words: skeletal classⅢ malocclusion, maxillary skeletal expansion, maxillary protraction, maxillary transverse deficiency, miniscrew, orthodontic camouflage treatment