TREATMENT OF SEVERE CROWDING WITH SELF-LIGATING FIXED ORTHODONTIC APPLIANCE

Abstract

Introduction: Crowding in orthodontics presents a discrepancy between tooth size and dental arch length. Crowding of teeth is more often diagnosed in mandibular dental arch. Crowding was classified as moderate (-5.1 mm or more of discrepancy), mild (-0.1 and -5 mm) of discrepancy, and no crowding (zero or a positive discrepancy) by W. Proffit. Over the last few years, the use of self-ligating brackets in orthodontics has progressed considerably. According to some authors, selfigating appliances are more ef- fective in treating moderate crowding. Aim: To present the treatment of cevere crowing of both dental arches without premolar extractions, using self-ligating fixed orthodontic appliance. Material and method: Male patient 12 years old was diagnosed with severe crowding in both upper and lower dental arches. Study cast analysis showed severe crowding of 8 mm in the upper and 9 mm in the lower dental arch with dental class I. Lateral cephalometric analysis showed slight mandibular retrogna- thism (SNB 78°) with skeletal class I (ANB 4°). There were no significant vertical skeletal deviations (SpP/ MP 20°, Bjork’s sum 389°, Jarabak 67,7%). Both upper and lower central incisors were retroinclined (I/SpP 102°, IMPA 95°). There were no deviations in maxillar corpus and mandibular corpus and ramus length. Treatment with self-ligating fixed orthodontic appliance was indicated. The active phase of the treatment lasted 26 months. During the treatment, interproximal reduction (IPR) was performed on upper and lower front teeth. Results and conclussion: Stable class I occlusion was acheieved. Both upper and lower dental arches were slightly expanded. Severe crowding was treated successfully Treatment result was stable, with no signs of relapse, with the overjet of 2 mm and overbite of 3 mm. Severe crowding in young patients can be succsess- fully treated without extractions with self-ligating fixed orthodontic appliance in cases of horizontal growth pattern ,with retroinclined upper and lower incisors.