A female patient suffering from severe crowding in the upper and lower teeth was treated using fixed metal braces to restore her smile and self-confidence.
Case Details: Severe Crowding in Upper and Lower Teeth
Ms. Z.A. came to Wonders Dentistry Center with a primary complaint of crowded teeth and an unbalanced smile to find a solution. Upon examination, we found the following:
Frontal View of the Jaws:
Severe crowding during biting, Canines are elevated, The midline of the teeth is slightly deviated to the right, and The lower front incisors require dental cleaning to remove tartar.
Right Lateral View of the Jaws:
In addition to the frontal view, there is significant rotation in the lower canine and first premolar. The first premolar does not participate in the bite, The patient also requires dental cleaning on this side, Left Lateral View of the Jaws, Partial open bite in the canine region. Partial posterior crossbite in the molar region, and Narrow V-shaped upper jaw with dental crowding.
Lower Jaw Arch View:
The condition is better than the upper jaw, but there is crowding and rotation in the lower canine and first premolar on the right side.
Additional Information:
Externally, the patient appears normal in the lower third of the face, with only slight crowding visible when smiling. The jaw relationship is normal from the facial profile.
Available Solutions for the Case
The only and best solution for this case is orthodontic treatment (braces). Other solutions would be more time-consuming, costly, and potentially harmful to the teeth. The types of braces that can be used include: Metal orthodontic, Clear aligners, and Lingual braces (metal braces placed behind the teeth)
The Best Solution: Metal Braces
The patient chose metal braces because they are relatively faster than clear aligners and lingual braces. To achieve the best results, the treatment plan included:
- Extraction of the first premolars (tooth number 4) in all quadrants of the mouth (two teeth in each jaw):This is necessary to create the space required for proper teeth alignment, Bringing the canines into the correct bite position. Correcting the bite relationship between the upper and lower jaws, Note: Other methods to create space in the jaw exist but are suitable for less severe cases or when less space is needed.
- Proper alignment and leveling of the teeth.
- Bringing the canines down to their natural position.
- Correcting the jaw relationship and bite.
- Fitting a retainer to maintain the results.
Steps to Achieve Satisfactory Results
What Are the Steps for Installing Braces with Brackets?
- Orthodontic treatment begins with a visit to an orthodontist for a diagnosis through a clinical examination.
- The orthodontist takes panoramic X-rays, lateral cephalometric X-rays, and diagnostic photos of the patient’s mouth and face (while smiling, at rest, and in profile) to study the case and monitor progress. These images are essential and not optional in orthodontic treatment.
- The orthodontist explains the case to the patient and the best treatment approach.
- The orthodontist installs the brackets and archwires to begin the orthodontic treatment.
- The patient starts follow-up visits at intervals determined by the orthodontist based on the stage and progress of the treatment.
- The orthodontist evaluates the progress using X-rays and images and discusses the progress with the patient.
- At the end of treatment, the orthodontist removes the braces and takes new X-rays and photos of the case.
- The orthodontist then installs a fixed retainer on the back of the front teeth or takes an impression to create a removable retainer for a specified period.
Number of Visits and Treatment Duration
The treatment duration was one year, keeping in mind that most orthodontic cases take anywhere from 6 months for very simple cases to 3 or 4 years for complex cases, depending on the patient’s age. This is all done with regular follow-ups with the orthodontist and adherence to their instructions.
The number of visits ranges from once a week to once a month, depending on the treatment phase and the procedure the patient will undergo during the next visit.
How Do You Know If You Need to Visit an Orthodontist?
Malocclusion (improper bite) is the main issue that encompasses many problems requiring orthodontic treatment. These problems can affect facial symmetry and appearance, leading to low self-esteem and even depression. In some cases, they can also cause difficulties in chewing, speaking, and maintaining oral hygiene.
Problems That Orthodontic Treatment Can Solve:
- Crowded Teeth: Caused by a mismatch between tooth size and jaw size, extra teeth, or improper extractions.
- Large Gaps Between Teeth: Cannot be resolved with prosthetics and are caused by a mismatch between tooth size and jaw size, genetic syndromes, or impacted teeth.
- Uneven Teeth.
- Protruding Front Teeth (Overjet): Should be treated to reduce the risk of injury during sports or falls.
- Impacted Teeth: If there is space and the tooth is in a favorable position to emerge from the bone and gums.
- Deep Bite: Caused by the upper teeth overlapping the lower teeth excessively.
- Anterior Crossbite: When the lower front teeth are ahead of the upper front teeth during biting.
- Posterior Crossbite: When the lower jaw is wider than the upper jaw, causing the upper teeth to fit inside the lower teeth.
- Anterior Open Bite: When the patient bites only on the back teeth, leaving the front teeth open.
- Posterior Open Bite: When the back teeth do not touch during biting, either on one side or both.
- Excessive Growth of the Upper and Lower Jaws at a Young Age.
- Underdeveloped Upper Jaw at a Young Age.
- Lost Spaces Due to Early Tooth Extraction Without Space Maintainers.
- Thumb Sucking at a Young Age.
- Tongue Thrusting at a Young Age.
Orthodontists Can Also Address Temporary Issues Like Teeth Grinding (Bruxism).
What Are the Advantages of Orthodontic Treatment?
Orthodontic treatment is a healthy solution for correcting the undesirable appearance of teeth caused by crowding, gaps, and other issues, without removing a large portion of the teeth or causing pain. Its advantages include:
- Reducing the Risk of Tooth Decay: By aligning the teeth, all tooth surfaces become exposed, making them easier to clean with a toothbrush and toothpaste.
- Improving Bite Function: It removes excessive pressure on a single tooth or group of teeth and corrects improper biting habits.
- Enhancing Appearance: After completing treatment, your smile will improve significantly, boosting your self-confidence and satisfaction.
- Pain-Free Treatment: Orthodontic treatment is generally pain-free.
- Improving Gum Health: After completing orthodontic treatment, gum health improves.
What Are the Capabilities of the Orthodontic Center?
At Wonders Dentistry Center, the following types of orthodontic treatments are available: Fixed metal braces, Clear aligners, Removable braces, Lingual braces (internal braces), Orthodontic treatment for teeth and jaw alignment, Damon braces, Orthodontic treatment can be performed for either the upper jaw, lower jaw, or both jaws simultaneously.
The center is also equipped with: Panoramic X-ray unit, Cephalometric X-ray unit, Digital imaging unit to record treatment progress step by step.
Final Result
A new member of the Wonders Dentistry Center family is happy with the results and her beautiful new smile.
