Orthodontic treatment of Class I malocclusion with severe crowding & anterior crossbite - 2

  Diagnosis:

    A female patient came with the chief complain of irregularly placed upper and lower teeth. The extraoral examination reveals mesoprosopic faceform, mesoocephalic headform, straight profile, competent lips, average nasolabial angle. The intraoral examination shows Class I molar relation, Class I canine relation with crowding in upper & lower anterior teeth, crossbite irt left lateral incisor, over retained lower second deciduous molar on both the sides & lower deciduous central incisor. Diagnosis is Angle's Class I malocclusion with crossbite irt left lateral incisor, upper and lower crowding and over retained lower second deciduous molars & lower deciduous central incisor.

Treatment Objectives: 

• To correct crowding in upper & lower anterior teeth
• To correct crossbite
• To achieve ideal overjet and overbite
• To correct smile

Treatment Plan: 

• Extraction irt 81, 75, 85
• Leveling and alignment 
• Inter-proximal reduction 
• Finishing and detailing

Treatment Progress: 

    The orthodontic treatment is started with banding in upper and lower first molars. The extraction of over retained lower second deciduous molars & lower deciduous central incisor is performed. The bonding is done in upper and lower arches with standard 0.022 inch MBT preadjusted edgewise appliance. The initial leveling and alignment process is started on 0.014 nickel‑titanium (NiTi) arch wire and GIC cement is placed on posterior teeth to open the bite. The inter-proximal reduction is performed in lower anterior teeth. The sequential change of arch wires are 0.016 nickel‑titanium (NiTi), 0.017 x 0.025 NiTi, 0.019 x 0.025 NiTi, 0.019 x 0.025 SS. After the crossbite is relieved and leveling & alignment is completed, posterior GIC bite block is removed. Finishing & detailing is done on 0.019 x 0.025 braided SS wire by settling elastics. The overall treatment duration is approximately 1 year. After removal of orthodontic appliance, lingual fixed retainer and removable essix retainer are given.

                                                                            

Treatment Results: 

    The post-treatment photographs showed Class I molar and canine relation, ideal overjet and overbite, average nasolabial angle, competent lips, well coordinated arches. The profile & smile are also improved. The pleasing smile is obtained with proper interdigitation of occlusion.