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“Orthodontic Management of Class I Malocclusion and Severe Crowding in a Hypodivergent Patient with an Unaesthetic Smile Arc” – A Case Report

DOI : https://doi.org/10.36349/easjdom.2021.v03i03.006
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The etiology of bimaxillary protrusion is multifactorial involving both genetic and environmental causes like mouth breathing, tongue and lip habits and tongue volume. The following case report shows management of class I crowding in a hypodivergent case with extraction of all first premolars. The results of the treatment produced a pleasant facial profile with attainment of good occlusion. The case required extraction of 1st premolars for correction of the proclined, forwardly placed and crowded upper and lower anterior teeth. Cephalometric evaluation revealed a Class I skeletal pattern with a horizontal growth pattern and clinical examination revealed presence of an orthognathic facial profile, an average overjet and overbite, crowding in maxillary and mandibular anterior region, potentially incompetent lips, increased lip fullness and lip strain with an unaesthetic smile arc and a decreased nasolabial angle. Following fixed orthodontic treatment by removal of all 1st premolars and with retraction of anterior segment, a marked improvement in patient's smile, facial profile and occlusion was achieved and there was a remarkable increase in the patient's confidence and quality of life. The profile changes and treatment results were demonstrated with proper case selection and good patient cooperation with fixed appliance therapy.

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Dr. Afroza Begum

Lecturer, Dept. of Pharmacology and Therapeutics, Shaheed Monsur Ali Medical College & Hospital, Uttara, Dhaka-1230, Bangladesh

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