Treatment of severe crowding with constricted arches in a patient with high angle Class I malocclusion: A case report

Abstract

The goal of orthodontic treatment in a severely crowded malocclusion is to obtain a harmonious face with a well-balanced soft tissue profile, functional occlusion and a consonant smile. Etiology involving both genetic and non-genetic factors are associated with severe crowding. This case report is on correction of class I severely crowded malocclusion in a vertical grower treated with extraction of all first premolars. Intra oral, extra oral and radiographic examination revealed skeletal Class I with straight profile, hyper divergent growth pattern, increased overjet and severe crowding in maxillary and mandibular dentition, constricted arches, potentially competent lips with increased lip strain and a non-consonant smile arc, treated with extraction of all 1st premolars, significant improvement in patient's smile, profile and occlusion were obtained. The successful results were obtained due to correct case selection and proper treatment planning. The meticulous space analysis and management without anchorage loss is a result of proper anchorage planning prior to extractions.