Arch Development and Orthodontics in an Adolescent Girl

C.A. had typical arch constriction, that is her dental arches were small and could not accommodate all her teeth, which came out crowded and crooked. The last tooth to erupt at adolescence is the upper canine, which understandably gets the short end of the bargain, and is pushed maximum out of alignment.

The first phase of treatment for this type of case is fitting a fixed expander called a “hyrax”, and bonding braces on all the teeth.

A few months later, as the arches develop and more space is made available, the braces allow the teeth to come into alignment.

Towards the end of the treatment, as the jaws have been developed and the teeth are almost straight, the expander is removed and the teeth and their roots are fine-tuned and ideally aligned with stiffer wires.

As we progress, we notice that the whole face and the smile have developed like a flower in bloom.

As the braces are removed, we notice that the upper dental arch is like a Roman arch, representing a healthy jaw and reassuring proper airway, jawjoint function, tongue positioning and last but not least, esthetics. The smile is wide and there are no dark “corridors” or shadows in the corners of the mouth.

C.A. before and after braces to develop her arch to create enough space to fit all her teeth. Eighteen month of braces gave her a life-long beautiful smile.