Highlights:1. Without extractions or orthognathic surgery, a differential diagnosis, utilizing three methods (DI, 3-Ring and Extraction Decision Tree) revealed that the patient's desire for conservative treatment was feasible.2. Despite 12mm of asymmetric crowding in the maxillary arch, the problem was treated to an optimal result without excessive arch expansion and incisal flaring by using PSL brackets.3. For the present patient, the anterior cross bite and deep bite were corrected simultaneously in ~5 months, utilizing anterior BTs and early light class III elastics as the principle active mechanics. Pink and White (P&W) dental esthetic score of 3. The worksheets for the DI, CRE, and P&W scores are attached within this case report.
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