h/o Rt U & L extraction of 1st premolar and removable appliance tried elsewhere resulting in flaring of anteriors.
o/e Bimaxillary proclination. Spacing between U & L anteriors with poor periodontal prognosis.

Tentative Treatment plan: Lefort I with AMO and lower subapical osteotomy along with orthodontia.

Beggs ortho treatment started to close spacing between anteriors and regain Rt 4's space. May require RCT of anteriors and splinting later.