Treatment of anterior crowding

ABSTRACT

A 31-year-old male patient presented for an orthodontic examination requesting treatment of a localized crowding in the frontal region.

Clinical and cephalometric examinations reveal a Class I skeletal and dental appearance with a normally divergent pattern. The arches have transverse diameters and shapes requiring expansion, requiring avoidance of excessive proclivity of the upper incisal group. A crossbite is present on tooth 4.3.

Crowding was quantified at 3.44 mm in the upper arch and 3.01 mm in the lower arch. The anterior Bolton Index of 74% highlights a mesio-distal size discrepancy between the anterior teeth, which contraindicates lower arch stripping and suggests a transverse expansion strategy.

The primary therapeutic objective is the resolution of anterior crowding through dental expansion and alignment, with attention to maintaining the profile and correct incisal inclination, while ensuring good occlusal and functional harmony.