PENATALAKSANAAN CROWDING ANTERIOR MANDIBULA DENGAN SCREW EXPANSION KOMBINASI MAXILLARY FLAT BITE PLANE

Abstract

Background: Orthodontic problems encountered in the community are dental crowding, which is generally caused by a discrepancy between tooth size and the length of the basal arch. This condition may result in tooth malposition, rotation, and overlapping, and can potentially compromise oral health. In addition, vertical malocclusion in the form of a deep bite frequently accompanies crowding cases and requires appropriate management. Purpose: To describe the management of mandibular anterior crowding accompanied by a deep bite using removable orthodontic appliances in the form of an expansion plate combined with a flat anterior bite plane. Case Report: A 25-year-old female patient presented with a complaint of crowded mandibular anterior teeth that had been experienced for several years and adversely affected esthetics and self-confidence. Clinical examination, study model analysis using the Pont, Korkhaus, Howes, and Thompson–Brodie methods, as well as cephalometric analysis using the Steiner method, revealed a skeletal Class I relationship with a mandibular arch space discrepancy of −3.4 mm and a deep bite caused by posterior tooth infraocclusion. Case Management: Treatment was performed using a mandibular expansion plate with screw activation of 20 × ¼ turns, which generated 2.4 mm of space, along with the use of an active maxillary plate with a T-spring to correct tooth malposition. Evaluation after three months of treatment showed an increase in mandibular inter premolar width of 3.5 mm, improvement in maxillary tooth alignment, and a reduction in overbite of 1 mm, although complete correction of mandibular crowding was not achieved. Conclusion: Removable orthodontic treatment using an expansion plate combined with a flat anterior bite plane may serve as an effective alternative for managing mild to moderate crowding accompanied by a deep bite.