Initial situation
- Patient first seen at age 6
- Minor preventive expansion of the upper dental arch performed at initial visit
- Growth monitored until comprehensive treatment began at age 13
- Tooth 1.3 malpositioned, the patient's main concern affecting her smile
The patient was first examined at age 6, when a minor preventive expansion of the upper dental arch was carried out before her growth was monitored over time.
The decision
Comprehensive treatment began at age 13 using the Damon bracket system to correct the bite, align the dental arches, and reposition tooth 1.3.
Timely preventive intervention in a growing patient can shorten and simplify the comprehensive phase of treatment.
The result
Comprehensive treatment took 16 months and produced a beautiful, harmonious, and stable smile, including correction of the previously malpositioned tooth 1.3.
Early preventive expansion followed by timed comprehensive treatment, with attention to detailing at the finishing stage, can produce an efficient and stable outcome.
About skeletal expansion & MARPE
Two-phase treatment that begins with early preventive expansion and growth monitoring, followed by comprehensive correction once the patient is ready, allows clinicians to take advantage of growth while reserving fixed appliance therapy for the definitive phase. Careful transverse assessment at the preventive stage and precise finishing mechanics at the comprehensive stage both contribute to the final result. This case reflects the general value of staged, growth-aware treatment planning.
Questions clinicians ask
Why was the patient treated in two phases?
The patient was first seen at age 6 for a minor preventive expansion and growth monitoring, then began comprehensive treatment at age 13 once she was ready for it.
What was the main aesthetic concern for the patient?
The position of tooth 1.3 had always bothered the patient and affected how she felt about smiling.
How long did the comprehensive phase take?
The comprehensive phase, using the Damon bracket system, took 16 months.
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Original case shared by Dr. Mark Radzhabov on Instagram @orthodont_mark · Published for professional education.
