Orthodontic Crowding Management — ORE Part 1 MCQ

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ModerateOrthodonticsOrthodontic Crowding ManagementORE Part 1

A 25-year-old patient has a Class I malocclusion with normal overjet, overbite and soft-tissue profile. The lower labial segment has 4 mm of crowding. All permanent teeth are present and sound. Which is the most appropriate orthodontic approach?

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Correct answer: C — Non-extraction alignment using limited interproximal reduction

Explanation lettering: B = shown as A · E = shown as B · A = shown as C · C = shown as D · D = shown as E

A is correct. In a Class I adult case with a normal profile and only 4 mm of lower anterior crowding, space can usually be created conservatively during alignment, for example by carefully planned interproximal reduction. IPR is an established adjunct for relief of orthodontic crowding. Four-premolar extraction would be disproportionate where there is no protrusion, major arch discrepancy or profile indication. Lower-incisor extraction is a selective compromise option, generally considered where there is greater lower anterior space deficiency and suitable tooth-size and occlusal relationships; it is not routine for this presentation. Mandibular advancement surgery treats a skeletal sagittal discrepancy, which is absent. Observation may be chosen if the patient declines treatment, but it is not the appropriate active treatment plan when correction is requested. ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/34865310/?utm_source=openai))

Reference: Gómez-Aguirre JN, et al. Effects of interproximal enamel reduction techniques used for orthodontics: A systematic review. Orthodontics & Craniofacial Research, 2022. https://pubmed.ncbi.nlm.nih.gov/34865310/