Initial situation
- Narrowing of the jaws
- Inward misalignment of the lateral incisors
- Dental arch asymmetry
- Excessive gum display when smiling
- Misaligned central line
The decision
This case is presented as a before-and-after outcome. As with other cases in this practice, the treatment plan followed a standard staged assessment addressing the arch narrowing, lateral incisor position, and midline discrepancy together.
The result
The patient finished treatment with a wide, open, and symmetrical smile, with the lateral incisors repositioned, arch asymmetry resolved, and the central line restored.
Inward lateral incisors are often a sign of underlying arch narrowing, and correcting arch width can help resolve both the tooth position and the midline discrepancy.
About skeletal expansion & MARPE
This case illustrates how inward-positioned lateral incisors frequently reflect an underlying transverse deficiency rather than an isolated tooth-positioning problem. Assessing arch width alongside individual tooth position and midline alignment allows the treatment plan to address the root cause rather than the symptom alone. Correcting the transverse dimension as part of a staged plan supports lasting improvement in both tooth position and overall smile symmetry.
Questions clinicians ask
Why were the lateral incisors positioned inward?
Inward lateral incisor position is often linked to insufficient arch width, which can crowd these teeth out of their ideal position within the arch.
How does correcting arch width affect the midline?
As arch asymmetry is resolved and space is redistributed evenly, the central line often comes into better alignment with the facial midline.
Is gum display always related to arch width?
Excessive gum display can have multiple causes, but when it appears alongside arch narrowing and crowding, addressing the transverse dimension is often part of a comprehensive treatment plan.
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Original case shared by Dr. Mark Radzhabov on Instagram @orthodont_mark · Published for professional education.
