Crowding Exo Case

  • Generalized crowding upper & lower dental arches
  • Class I molar relationship right side, class III molar relation left side (due to early loss of deciduous molars & mesial migration of 1st permanent molar)
  • UR2 + UL2 are in lingual cross-bite
  • UR3 + UL3 buccally malposed, mesially tipped
  • Overjet +1mm, Overbite +1mm (clinically & from the study model)
  • LR5 + LL5 are in lingual cross-bite
  • Forced bite on the lower left side
  • Big size upper incisors


  • Skeletal class I, horizontal growth pattern
  • Dental: severe upper & lower dental arch crowding due to tooth size/ arch size discrepancy
  • Bimaxillary protrusion
  • Crowding and proclination are two aspects of the same phenomena

Treatment Plan

  • TPA + Lingual arch to reinforce upper & lower anchorage, the brachyfacial type is a positive factor for natural anchorage
  • Space creation by extraction of the UR4, UL4, LL4 & LR5
  • Fixed comprehensive orthodontic appliance therapy
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