Treatment planning from the lateral cephalogram and study casts alone has led to unsuccessful camouflages of three-dimensional skeletal problems. Skeletal relationships can identify patients who are more susceptible to periodontal breakdown. The transverse skeletal discrepancy is a reliable prediction of increased gingival recession and indications for treatment will be highlighted. This session will emphasize diagnosis and treatment strategies that are designed to correct apical base relationships (in three planes of space) for improved stability, periodontal health and frontal dentofacial esthetics. Early treatment in the deciduous or early mixed dentition is ideal for correction of transverse skeletal abnormalities orthopedically, however, guidelines will be reviewed for adolescents as well as adults.