Correction of severe bimaxillary protrusion with first premolar extractions and total arch distalization with palatal anchorage plates

• A young woman with bimaxillary protrusion sought treatment.
• Profile improvement after premolar extraction treatment was not satisfactory.
• Additional total distalization by palatal plate corrected the severe protrusion.
• This treatment modality might be a feasible option for bimaxillary protrusion.

Correction of a severe protrusive soft tissue profile without orthognathic surgery can be challenging. This case report describes the treatment of a young woman with a severe bimaxillary protrusion. Orthodontic treatment included extraction of her 4 first premolars and total arch distalization of both arches using a palatal plate appliance. The total treatment time was 24 months. Her occlusion and facial appearance were significantly improved.