Dento-maxillary disharmony class I malocclusion with severe crowding, crooked canine, midline shifting and lip incompetence management: A case report

Objective: This case report aimed to provide treatment sequential DDM to meet the patient’s expectations. Case Report: Before starting the treatment, 2 first upper premolar needed to be extracted to gain space for severe anterior crowding teeth and 2 second lower molar because the teeth were not in good condition. After extraction, bracket placement with fixed appliance 0.22” MBT prescription and NiTi wires sequences were done for initial leveling. When it has already leveled, start for canine retraction using an elastomeric chain in wire SS 0.016x0.022-inch. Then, T-loop bends were used for anterior retraction in the same wire. Finishing detailing using SS 0.017x0.025-inch. The last one, Hawley Retainer, was used as a retainer. Results: The final results were as expected by the patient. She gained confidence through her new smile, and the orthodontist obtained what it needed for ideal occlusion except for Class I molar relationship because mesialization of the second lower mandibular tooth, and distalization of the anterior mandibular region but Class I canine were obtained, no rotation, no space, flat occlusal plane, and excellent crown angulation and inclination. Also, the patient’s lip became competent. Conclusion: This case concludes that the patient was happy with the overall treatment results and was satisfied with the pleasant and esthetic smile achieved at the end of the treatment.