Correction Of Overcrowding With High-Angle Profile Through Alveolar Remodeling

This case involves an adult patient with severe dental crowding in both arches, broad buccal corridors, upright or lingually inclined incisors, lingually inclined posterior teeth, narrow alveolar arches, and a straight facial profile. Through orthodontic transverse expansion of the dental arches, torque correction, vertical control, and alveolar arch remodeling, the crowding was resolved. The final outcome achieved aligned dentition, stable occlusion, and preserved facial aesthetics. An 18-year-old patient presented with "dental misalignment." Clinical examination revealed a high angle, prominent buccal corridors during smiling, and a straight profile. Intraorally, teeth #13 and #43 were fully labially displaced, upper incisors and lower incisors were lingually inclined, and posterior teeth were lingually inclined. Maxillary crowding measured 10 mm, and mandibular crowding was 8 mm. Treatment included rapid maxillary expansion, molar distalization, and anterior torque correction. Following alveolar bone remodeling, PASS brackets (Hangzhou SHINYE) were used for alignment and occlusal adjustment, restoring normal labial inclination of the anterior teeth while maintaining the pretreatment facial profile. Extraction-based treatment is commonly used for severe crowding. However, it may overlook the alveolar bone's potential remodeling ability and lead to diagnostic bias. Alveolar bone retains lifelong remodeling capacity. By implementing staged orthodontic tooth movement, alveolar arch expansion and reshaping can harmonize the dental and alveolar arch morphology, effectively resolving severe crowding while preserving soft tissue aesthetics. Taking full advantage of alveolar bone remodeling capabilities to optimize diagnostic planning and by help of physiological anchorage control facilitates alveolar arch reshaping while non-extraction.