Nonextraction Management of Severe Crowding in a Growing Patient with Borderline Malocclusion: Case Report

A borderline case presents with mild skeletal disharmony or orthodontic problems due to arch length discrepancy and migration of teeth or a combination of these but is masked by a balanced soft tissue relationship. This case report describes one such borderline case of a 13-year-old girl who complained of irregularly placed upper and lower front teeth. Extraoral examination revealed balanced soft tissue with a mild convex profile, competent lips, and an average nasolabial angle. Intraorally, she had mixed dentition with flush terminal in primary molars and a class I relation in the permanent molars, severe crowding in the lower anterior, and congenitally missing permanent right laterals. A nonextraction protocol was followed, harnessing the pubertal growth spurt to alleviate the crowding and thereby preserving the soft tissue harmony.