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This 12 years old girl visited us with a chief complain of crooked teeth and inability to close her lips efficiently.

O/E – She has a convex facial profile with deficient chin. She had incompetent lips due to protruding teeth. She had a narrow smile with crowded teeth. Some of the permanent teeth erupted below the milk teeth which were still retained in the mouth. All orthodontic records ie. Study Models, X-rays namely lateral cephalogram and OPG and intra and extraoral photographs were taken.

Study model analysis, Lateral cephalogram tracings and photographic evaluation revealed that she had –

Underdeveloped lower jaw and normally developed upper jaw. She had a vertical jaw growth tendency. Upper front teeth were proclined and lowers were crowded. Arches were narrow and underdeveloped. Excessive overjet and overbite. Facial profile was typically convex with underdeveloped L jaw.

All the milk teeth were extracted to allow eruption of permanent teeth. She had regular metal braces to align her dentition. After 16 months, all the permanent teeth had erupted, the upper and lower arches were well aligned, however the face and smile needed further improvement.

Hence the permanent first premolars were extracted to allow retraction of teeth to improve her smile and facial profile.

The treatment then continued for another 6 months with finishing mechanics. The results were dramatic. Her facial features improved. The lower jaw was in good proportion with the upper jaw. Dental arches and teeth arrangement showed good alignment which was esthetically pleasing and functionally efficient.

The change had a positive influence on her personality. The girl smiled and laughed more often, she had a positive self-esteem and was now confident. Her parents were extremely happy to see this shy, submissive child evolve into an outgoing and confident youngster.Right ORTHODONTIC diagnosis and timely, well planned treatment made it possible for her to be an altogether different individual.

Here is the comparison of her before treatment and after treatment photographs-