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Since childhood, the patient felt that the teeth were crowded and misaligned, prone to food impaction, and that smiling was unappealing. The patient also had a habit of mouth breathing and snoring during sleep. The patient presented seeking advice on whether orthodontic treatment could improve the dental crowding and the respiratory obstruction.

Treatment Plan:

Analysis of the patient's lateral cephalogram revealed a maxillomandibular discrepancy, with mandibular overgrowth (prognathism). The tongue position was abnormal, with the hyoid bone located inferiorly. The posterior occlusal relationship was abnormal, necessitating distalization of the mandibular molars. The correction plan employed fixed orthodontic appliances with MAS mini-screw (temporary anchorage device) support to move the mandibular molars distally, improving the posterior occlusion while creating space for lower anterior alignment. Camouflage treatment of the lower anterior teeth was undertaken to address the forward mandibular position resulting from the skeletal discrepancy, combined with muscle function training to establish a normal tongue position and improve the mouth breathing and snoring symptoms.
 

Treatment Outcome:

As can be seen, the anterior smile line has improved significantly, and the entire lower face appears softer and more natural. The buccal corridor ratio is more appropriate. The exposure of the upper anterior teeth when smiling is perfect. The patient reported that snoring has significantly improved, food impaction is no longer an issue after resolving the crowding of the lower anterior teeth, and the chin profile has retracted slightly, looking more natural.