Conservative treatment of a Class I malocclusion with 12 mm overjet, overbite and severe mandibular crowding

Introduction: A female patient aged 12 years and 2 months had molars and canines in Class II relationship, severe overjet (12 mm), deep overbite (100%), excessive retroclination and extrusion of the lower incisors, upper incisor proclination, with mild midline diastema. Both dental arches appeared constricted and a lower arch discrepancy of less than -6.5 mm. Facially, she had a significant upper incisors display at rest, interposition and eversion of the lower lip, acute nasolabial angle and convex profile. Objective: To report a clinical case consisting of Angle Class I malocclusion with deep overbite and overjet in addition to severe crowding treated with a conservative approach. Methods: Treatment consisted of slight retraction of the upper incisors and intrusion and protrusion of the lower incisors until all crowding was eliminated. Results: Adequate overbite and overjet were achieved while maintaining the Angle Class I canine and molar relationships and coincident midlines. The facial features were improved, with the emergence of a slightly convex profile and lip competence, achieved through a slight retraction of the upper lip and protrusion of the lower lip, while improving the nasolabial and mentolabial sulcus. Conclusions: This conservative approach with no extractions proved effective and resulted in a significant improvement of the occlusal relationship as well as in the patient’s dental and facial aesthetics.