Treatment for the correction of crowding > 6 mm

Abstract

A 34-year-old female patient presented for an orthodontic examination with the request to resolve anterior crowding of the lower arch, which she reported was the cause of frequent tartar accumulation and difficulty with daily oral hygiene.

Clinical and cephalometric examination revealed a Class II skeletal structure (ANB 5°) with a normal divergent pattern, adequate transverse diameters, and a Class I dental structure. The lower incisors were proclined (IMPA 100°), while the upper incisors were normally inclined.

Lower anterior crowding was quantified at 6.38 mm, with an anterior Bolton Index of 81.1%, indicative of mesio-distal discrepancy between the anterior teeth of the two arches.

The primary therapeutic objective is the resolution of lower crowding through dental alignment, with attention to managing the inclination of the lower incisors and maintaining overall occlusal stability.