The present case report sheds light on the treatment of a skeletal Class III malocclusion with severe tetracycline stains and associated enamel hypoplasia. Contrary to popular belief, premolar extraction is a viable alternative to orthognathic surgery in certain patients. A patient’s final expectations may need to be lowered in case of associated extensive staining and enamel hypoplasia. Fixed orthodontic therapy may require specific bonding processes to reduce bracket ‘pop outs’ and to achieve optimal treatment durations.