Class III surgical/orthodontic cases.  Patients that display significant class III malocclusions will many times require orthognathic surgery in cooperation with their orthodontic treatment (once growth has ceased).  It is not uncommon to find the upper incisors flared facially while the lower incisors are retroclined lingually.  It is important to consider the airway, overbite and profile when determining if the mandible needs to be positioned distally, the maxilla mesially or both.  Since it is wise to wait on definitive orthodontic treatment until growth has stopped, we will sometimes pursue a first phase of upper braces while the patient is growing to facilitate a nice smile and increased self-confidence.