Mandibular Crowding: Diagnosis and Management—A Scoping Review

Abstract

Background: Crowding is the most frequent malocclusion in orthodontics, with a strong hereditary tendency. It already occurs in pediatric age and is mainly hereditary. It is a sign of a lack of space in the arches, and is not self-correcting, but can worsen over time. The main cause of the worsening of this malocclusion is a progressive and physiological decrease in the arch perimeter. Methods: To identify relevant studies investigating the most common possible treatments for mandibular dental crowding, a comprehensive search of PubMed, Scopus and Web of Science was conducted encompassing the last 5 years (2018–2023) using the following MeSH: “mandibular crowding AND treatment” and “mandibular crowding AND therapy “. Results: A total of 12 studies were finally included. An orthodontic treatment cannot ignore the concept of “guide arch”, which concerns the lower arch, because of the objective difficulty in increasing its perimeter; the bone structure of the lower jaw is more compact than that of the upper one. Its expansion, in fact, is limited to a slight vestibularization of the incisors and lateral sectors that may be associated with a limited distalization of the molars. Conclusions: There are various therapeutic solutions available to the orthodontist, and a correct diagnosis through clinical examination, radiographs and model analysis are essential. The decision of how to deal with crowding cannot be separated from an overall assessment of the malocclusion to be treated.

Root Resorption during Orthodontic Treatment with Clear Aligners vs. Fixed Appliances—A Systematic Review

“…To avoid or lower the chances of root resorption, it is suggested to use light and regular orthodontic forces instead of shorter and stronger ones. Some argue that intermittent forces, such as those exerted by aligners, versus continuous forces from fixed appliances, result in distinct types of pressure [67][68][69]. According to certain sources, intermittent pressure may permit the cementum around the root to repair itself.…”

Perceived Orthodontic Needs and Attitudes towards Early Evaluation and Interventions: A Survey-Based Study among Parents of Italian School-Aged Children

“…Crowded anterior teeth and protruding upper teeth were the most observed issues related to teeth alignment by these survey participants. Interestingly, these features were found to have a major negative impact on facial attractiveness [ 32 , 33 ]. Instead, only a minority of parents found functional problems in their children.…”

A scanning electron microscopy investigation of the precision of three orthodontic bracket slot systems

“…As an illustration, while retracting a maxillary incisor to mitigate an overjet, the interaction between the bracket and archwire leads to the palatal inclination of the crown, accompanied by the labial movement of the tooth’s root. The application of torque primarily in the maxillary incisors is essential for addressing the movement between the archwire and bracket, intending to achieve optimal inter-incisal angle, appropriate incisor contact, and sagittal adjustment of the dentition to attain an ideal occlusion [ 15 , 16 ], both in crowded and spaced dentitions [ 17 , 18 ].…”