In the following severely crowded orthodontic case I will show how the malocclusion was resolved by extracting and replacing the maxillary first molars and extracting a single mandibular incisor. Several different treatment alternatives were considered and discussed.
Skeletal Considerations: The Sassouni Plus tracing demonstrates a balanced skeleton both horizontally and vertically (Fig. 1). A to B point is +2.0 mm and ANS to Pogonion is +1.3 mm. The tip of the ANS is located on the Anterior Arc representing a properly positioned maxilla horizontally. Therefore, skeletally the patient is classified as Class I (tendency III). When the teeth fare occluding the lower border of the mandible lies between the two lower scribed red arcs but is slightly beyond the age-related blue arc. Therefore, vertically the skeletal classification is normal to a slightly open skeletal vertical dimension.1 (Figs. 1, 2, 3)
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