Correction of upper incisor proclination by applying lingual crown torque with pre adjusted lingual brackets in a skeletal-class iii patient – case report

Abstract

BACKGROUND: After levelling and alignment in skeletal Class III patients with upper anterior crowding, the upper incisors usually have excessive proclination. In these cases, the upper incisors’ axial proclination need to be reduced to improve esthetics. CASE REPORT: This case report presents an invisible orthodontic treatment of a 24-year-old adult female patient with skeletal Class III relationship, anterior crossbite, proclined upper incisors, and reduced incisor showing. Patients denied extraction and interproximal reduction. With multi-slotted lingual brackets and straight archwires, we applied lingual crown torque to upper anterior teeth to reduce axial proclination. The resulting uprighted position of upper incisors led to increased incisor showing. A good smile and stable occlusion were obtained after 15 months of active treatment. CONCLUSION: The use of lingual brackets to apply lingual crown torque helps to reduce axial proclination and increasing upper incisor showing without interproximal reduction nor extraction in skeletal Class III patients with upper anterior crowding.