Simple treatment of a complex malocclusion: a case report

Clinical signs of tooth-size– arch length discrepancy are crowding, impaction, and incisor proclination. The controversy persists over whether to increase the size of the arch by expansion or decrease the size of the teeth by interproximal enamel reduction or extraction to resolve the discrepancy. This report describes the treatment of a 17-year-old girl with a severe tooth size-arch length discrepancy. The patient had a mild Class II skeletal relationship, a high mandibular plane angle, a Class I molar relationship, bilateral posterior cross bites, and deviated midlines. The final treatment protocol was non-extraction treatment of both arches using passive self-ligate brackets. Results and The final treatment result was satisfactory. Proper over- bite and over jet, facial balance and good occlusion were achieved. Expansion of posterior segments and distal movement of molars solved tooth size-arch length discrepancy.