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.