Malocclusion

Dental Crowding

Common terms used for dental crowding are malocclusion or bad bite or misaligned dental arches or crooked teeth etc.  Dental crowding occurs when there is a discrepancy between tooth size and jaw size.  When Jaw size is smaller than the teeth size and there is not enough space for teeth to erupt in the proper position. 

There are 2 sets of teeth in humans. Baby teeth or milk teeth and permanent teeth. Baby teeth are smaller in size and sometimes baby teeth are perfectly aligned but as soon as permanent teeth erupt, it results in crowding. This problem can be solved with the help of braces, but it needs proper diagnosis whether the problem is skeletal or dental. Determination of the proper etiology of crowding will have a significant effect on the treatment planning and reults.

01

skeletal Issue

It is possible to have crowding because of skeletal abnormalities for example increased or decreased jaw size also known as macrognathia or micrognathia. Macrognathia means abnormally large jaws whereas micrognathia is a term used to describe a lower jaw smaller than normal.

It is difficult to treat skeletal issues with braces only but if the problem is mild to moderate and not severe then some modification of growth is possible in growing patients or the skeletal discrepancy can be camouflaged in adults.

This needs proper diagnosis and treatment planning. 

02

dental issue

Crowding because of dental issues is a very common issue and occurs when permanent teeth do not erupt at the proper position in the jaw. When permanent teeth are erupting into the mouth, they follow the path which is of ease and do not have resistance which means they prefer to grow into whatever space is available. This might result in dentoalveolar crowding, which means teeth coming at an angle, can be rotated, overlapping making the mouth uncomfortable. 

This can be treated with braces. Proper diagnosis and treatment planning is important.

An orthodontist should keep three things in mind during treatment planning.

Treatment done by Prof. Irfan Qamruddin

case report

A girl visited with the complaint of uneven teeth, she said her teeth are sticking out and giving her an unpleasant smile. She needed her teeth to be fixed. 

In order to plan the case proper examinations should be done

examination

making a start

For examination, it is required to take proper photographs, impressions, x-rays (cephalometric and Orthopantogram).  Proper extraoral and intraoral examinations should be done.

In extraoral examination patient’s facial profile, soft tissue analysis and temporomandibular joint analysis should be done. Intraoral examination reveals number of teeth present and missing, relationship of teeth with other teeth, soft tissue examination example, frenum, gingiva etc.

After doing all the analysis careful decision needs to be taken. whether extraction is needed or not, in some cases extractions are mandatory to accommodate all teeth in space available in dental arches whereas in some cases space creation can be done without extraction with the help of fixed orthodontic therapy.

 

extraoral examination

Extraoral examination shows straight facial profile with competent lips.

intraoral examination

Extraoral examination shows maloclussion.

Our ultimate aim is to achieve patient satisfaction with orthodontic goals in mind.

1. Functional Efficiency
2. Structural Balance
3. Esthetic Harmony

treatment plan

Treatment plan was to achieve spaces in dental arches without extraction because patient’s facial profile was straight and lips were competent.  fixed orthodontic therapy was done.

It is very important to take care of oral hygiene during orthodontic treatment, watch this video to learn how to maintain oral health.

Post treatment pictures

patient satisfaction achieved
100%

crowding case

Before

After

patient satisfaction achieved
100%

crowding case

Before

After

patient satisfaction achieved
100%

important things you should know

Questions And Answers

You can take your child to an orthodontist for the first consultation at the age of seven.

A crossbite is a dental condition in which teeth alignment is disturbed. This can affect anteriorly on the front teeth or posteriorly that s back teeth. This can be treated with fixed orthodontics or clear aligners.

It is never too late to get orthodontic treatment. Prof. Irfan Qamruddin at IIOCO has done orthodontic treatment of an adult at the age of 65.

 

Sometimes malocclusion may lead to improper distribution of masticatory load which may effect oral health and can 

When jaw size is smaller than tooth size it may result in malocclusion. 

Yes! parafunctional habits like thumbsucking or finger sucking or prolonged use of pacifiers may lead to malocclusion.

It is very important to have primary teeth because primary teeth make space and guide adult teeth into proper position. If primary teeth are lost too early it may lead to lead to malocclusion. It is always advisable to save space by making space maintainers

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