Crowding Exo Case
- Generalized crowding upper & lower dental arches
- Class I molar relationship right side, class III molar relation left side (due to early loss of deciduous molars & mesial migration of 1st permanent molar)
- UR2 + UL2 are in lingual cross-bite
- UR3 + UL3 buccally malposed, mesially tipped
- Overjet +1mm, Overbite +1mm (clinically & from the study model)
- LR5 + LL5 are in lingual cross-bite
- Forced bite on the lower left side
- Big size upper incisors
Diagnosis
- Skeletal class I, horizontal growth pattern
- Dental: severe upper & lower dental arch crowding due to tooth size/ arch size discrepancy
- Bimaxillary protrusion
- Crowding and proclination are two aspects of the same phenomena
Treatment Plan
- TPA + Lingual arch to reinforce upper & lower anchorage, the brachyfacial type is a positive factor for natural anchorage
- Space creation by extraction of the UR4, UL4, LL4 & LR5
- Fixed comprehensive orthodontic appliance therapy
