A problem often confronting the orthodontist is that of missing molars. In evaluation of the individual case, the decision as to space closure or space regaining and eventual prosthetic reconstruction can be perplexing. Various diagnostic criteria, such as skeletal relation, arch-length analysis, inclination of teeth, and dental esthetics, must be evaluated. On the basis of this diagnostic information, a treatment alternative is chosen to correct the malocclusion. The solution may be found in maintaining space, necessitating post-orthodontic prosthetic replacement, or closing space and thus avoiding the need for artificial teeth. This case report evaluates the management of a 32 year old adult female patient having a mutilated malocclusion with multiple missing 1st permanent molars. It was managed by routine orthodontic treatment which involved protraction of permanent 2nd molars in the space available in the missing 1st molar region. Cephalometric values revealed proclined and forwardly placed upper and lower front teeth, hence we sought the need to extract premolars as the nasolabial angle was acute and premolar extractions in this case would be needed for the convex facial profile correction. After the treatment, a marked improvement in patient's smile, facial profile and occlusion was achieved and there was a remarkable increase in the patient's confidence and quality of life. Correction of the mutilated malocclusion was achieved without tipping, rotation of the posterior teeth, or other problems. The profile changes and treatment results were demonstrated with proper case selection and good patient cooperation with fixed appliance therapy.