This document presents a case report on the orthodontic treatment of a 16-year-old female patient named Pinki who presented with crowding in both dental arches. She had previously undergone unsuccessful treatment with a removable appliance by an underground student. The current treatment involved fixed appliance therapy including initial leveling and alignment with round wires followed by use of rectangular wires to correct minor irregularities and achieve arch contraction. Interdigitation was improved with elastics. Post-treatment intraoral photographs show significant improvement in crowding and occlusion.

1. WELCOME

2. Presented by:
Dr. Md. Ishtiaq Hasan
BDS, FCPS-II Trainee,
Dept. of Orthodontics, DDCH
Supervisor:
Prof. Dr. Md. Zakir Hossain
BDS, PhD(Japan)
Prof. & Head,
Dept. of Orthodontics,
DDCH.
ORTHODONTIC MANAGEMENT
OF A YOUNG GIRL WITH
CROWDING: A CASE REPORT

3. We will
try our
best.

4. EXTRA-ORAL EXAMINATION

5. Pt. name: Pinki
Age: 16 yrs
Came from Noakhali
Started orthodontic treatment one year back
by an underground student with removable
appliance
But the patient was unhappy with the
treatment.
So, we decided to start her treatment with
fixed appliance.

6. Clinical Examination
Shape of the head : Mesocephalic
Profile Analysis : Convex
Shape of the face : Oval
Facial symmetry : Symmetrical
Lips : Competent
Upper lip line : Normal
Lower lip line : Normal
Naso-labial angle : Normal
Labio-mental depression : Shallow

7. Intra-oral photographs

8. intra-oral photographs
The patient was in the permanent dentition
overjet 5 mm and overbite 4 mm.
Both upper and lower anterior segment of jaws were crowded.
Molar & canine relationships were Class I on both sides.
Her oral hygiene was good.

9. Model analysis
Remarks: Crowding in both the arches due to tooth jaw
discrepancy.
Upper arch Lower arch
Arch perimeter - Total tooth
material = 89mm – 100mm
= -11 mm
Arch perimeter -Total tooth material
= 78- 90mm
= -12 mm

10. Radiographic examination
Patient was using removable appliances
All 1st premolars were extracted
Canines were tipped
No pathological lesion is noted

11. Fig: Initial leveling and alignment by
0.014 ss round wire with multi-loop.
TREATMENT PROGRESS

12. Fig: Correction of minor irregularities by
0.016 ss round wire with multi-loop.

13. NEED COUPLE FORCE FOR
ROTATIONAL MOVEMENT

15. Fig: Arch contraction by .016*.022 ss
rectangular wire with tear drop loop.

16. Fig: Arch contraction – right side.

17. Fig: Arch contraction – left side.

18. Fig: Inter-digitation by up-down elastics.

19. POST TREATMENT INTRA-ORAL
PHOTOGRAPH
BEFORE AFTER

21. Overjet and overbite= Canine relationship=
Molar relationship=

24. POST TREATMENT EXTRA-ORAL PHOTOGRAPHS