Orthodontic treatment of Class I malocclusion with highly placed canines, severe crowding, rotations in upper anterior - 10

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  Diagnosis:

    A female patient came with the chief complain of irregularly placed upper and lower front 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 severe crowding in upper & lower anterior teeth, highly placed upper canines, overretained teeth in upper right & left 2nd deciduous molar, severe rotations present in upper central incisors. Diagnosis is Angle's Class I malocclusion with highly placed canines & severe crowding.


Treatment Objectives: 
  • To correct crowding in upper & lower anterior teeth
  • To level & align highly placed canines
  • To correct rotations of upper central incisors
  • To achieve ideal overjet and overbite
  • To correct smile

Treatment Plan: 
  • Extraction irt 55,65 
  • Leveling and alignment 
  • Inter-proximal reduction 
  • Finishing and detailing

Treatment Progress: 

    The orthodontic treatment is started with banding and bonding in upper and lower arches with standard 0.022 inch MBT preadjusted edgewise appliance. Transpalatal arch is fabricated & placed in upper arch. The initial leveling and alignment process is started on 0.014 nickel‑titanium (NiTi) arch wire. The inter-proximal reduction is performed in upper and lower anterior teeth. The sequential change of arch wires are 0.016 nickel‑titanium (NiTi), 0.017 x 0.025 NiTi, 0.017 x 0.025 SS. The upper right canine is distalized on 0.017 x 0.025 SS archwire & incorporated in the archform by piggyback mechanics. In upper arch right and left deciduous 2nd molars are extracted & allow natural eruption of permanent 2nd premolars. The bonding of 2nd premolars done and leveling & alignment is completed. Finishing & detailing is done on 0.016 SS archwire by settling elastics. The overall treatment duration is approximate 1.5 years. After removal of orthodontic appliance, removable essix retainers 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.

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