Treatment in patient with severe crowding.
This article describes a treatment with SparkTM Clear Aligners performed in a 19-year-old male patient, who presented at the time of consultation with irregularly placed upper and lower front teeth.
Dr. Arya S Prasad*, Dr. Arya S Prasad is a Consultant Orthodontist practicing across the South Chennai region. She earned her Bachelor of Dental Surgery from Sathyabama Dental College, Chennai, and went on to complete her Master of Dental Surgery in Orthodontics and Dentofacial Orthopedics from Saveetha Dental College and Hospital, Chennai. She also holds the prestigious degree of Membership in Orthodontics from Royal College of Surgeons, Edinburgh, United Kingdom. She is currently serving as an assistant professor and Consultant Orthodontist at Saveetha Dental College and Hospitals. She is also working as consultant Orthodontist to various clinics in and around Chennai and Pondicherry. She is actively involved in academics and clinical orthodontic practice, with a focus on delivering ethical and latest evidence-based orthodontic care. | 
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Clinical Finding
- Class I molar relationship bilaterally
- Proclaimed upper arch
- Crossbite irt 15
- Supernumerary teeth present
- Severe crowding in upper and moderate crowding in lower arch
Modalities
- Arch expansion
- Level and Align
- IPR
- Posterior bite turbos
- Advised extraction of supernumerary (patient was not interested to extract so proceeded with non-extraction approach)
Pre treatment
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Post treatment
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Description of treatment plan
Bilateral expansion of the upper and lower arch. Bite Turbo were added on posterior teeth to assist the disocclusion for anterior cross bite correction. Spark 20 plan was chosen using all active aligners with TruGENTM material and followed 9 days aligner wearing protocol. Strategic interproximal reduction (IPR) was performed in the anteriors to create the necessary space for proper alignment and proclination correction. This approach allowed a gradual application of orthodontic forces, giving the occlusion and tissues ample time to stabilize the periodontal tissue.
Treatment Result
The chief complaint of patient was properly addressed, cross bite, upper and lower crowding and rotation were corrected. At the conclusion of the treatment, the patient achieved excellent dental alignment and a stable occlusal relationship, particularly in the anterior region.
Conclusion
This case report demonstrates that in patients with a history of crowding, supernumerary teeth - Spark 20 plan was used to achieve arch expansion and rotation correction while stabilizing the occlusion and supporting tissues. The favorable outcome achieved with the Spark 20 system, along with strategic expansion and IPR supports the adoption of conservative orthodontic protocols focused on occlusal and tissue stability.
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Images courtesy of Dr. Arya S Prasad. Images have not been altered. Ormco is a medical device manufacturer and does not dispense medical advice. Clinicians should use their own professional judgment in treating their patients.
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Case 4: Treatment in adult patient with moderate crowding and Deep bite
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