Initial situation
- Severe crowding
- Disrupted occlusion in the posterior region
- Edge-to-edge anterior bite
The decision
The case is shown here as a before/after outcome. The treatment plan followed standard staged assessment to correct the severe crowding, restore posterior occlusion, and resolve the edge-to-edge anterior bite.
The result
Severe crowding was corrected, proper occlusion was restored in the posterior region, and the edge-to-edge anterior bite was resolved. The smile arc and the patient's facial shape both changed as part of the outcome.
Correcting severe crowding and an edge-to-edge anterior bite together can produce visible changes in smile arc and facial shape, beyond tooth alignment alone.
About skeletal expansion & MARPE
Severe crowding combined with a disrupted posterior occlusion and an edge-to-edge anterior bite often reflects an underlying transverse or sagittal discrepancy that constrains the whole arch. Correcting the occlusion and alignment together, rather than addressing crowding in isolation, is more likely to produce the kind of smile arc and facial change seen in this case. General staged transverse and occlusal assessment supports this integrated approach.
Questions clinicians ask
What was the main occlusal problem in this case?
The patient presented with severe crowding, disrupted posterior occlusion, and an edge-to-edge anterior bite.
Did the patient's facial appearance change?
Yes, the smile arc and the patient's facial shape both changed as part of the treatment outcome.
What is an edge-to-edge bite?
An edge-to-edge bite describes an anterior relationship where the upper and lower incisors meet at their edges rather than overlapping, as seen in the initial presentation of this case.
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Original case shared by Dr. Mark Radzhabov on Instagram @orthodont_mark · Published for professional education.
