عيادة الدكتور سعيد محمد ازهر السماك لطب وتقويم الأسنان

01/09/2025

Case Description
A patient presented with a skeletal and dental Class III malocclusion associated with a constricted maxilla. Clinical and radiographic evaluation revealed maxillary transverse deficiency with posterior crossbite and an anterior crossbite due to the skeletal discrepancy. The initial molar and canine relationships were Class III bilaterally, with proclined mandibular incisors and retroclined maxillary incisors contributing to the negative overjet.

Treatment Plan
A non-surgical camouflage approach was adopted. The treatment objectives included correction of the transverse deficiency, establishment of a functional and esthetic occlusion, and improvement of facial balance. Maxillary expansion was performed using a bonded rapid maxillary expander to address the transverse constriction. After adequate expansion, comprehensive fixed appliance therapy was initiated in both arches. Mechanotherapy included alignment and leveling, space coordination, and the use of intermaxillary elastics to aid in the sagittal correction and camouflage of the Class III skeletal base.

Treatment Outcome
At the end of treatment, the patient demonstrated a well-coordinated arch form with resolution of the posterior crossbite. Dental camouflage was achieved, resulting in a Class I incisor, canine, and molar relationship. The overjet and overbite were normalized, and facial esthetics were enhanced. The final occlusion was stable, functional, and met the treatment objectives without the need for surgical intervention.

18/08/2025

Case Description

A 10-year-old female patient presented with skeletal Class III malocclusion characterized by anteroposterior maxillary deficiency and constricted maxilla affecting both the anterior and posterior regions. The skeletal profile showed maxillary retrusion relative to the mandible, producing a concave facial profile. The dental profile revealed anterior crossbite and posterior transverse deficiency.

Treatment Progression

Phase I: Rapid Maxillary Expansion (RME)

A rapid maxillary expansion appliance was placed to address the transverse deficiency.

Successful expansion was achieved, evidenced clinically by the appearance of a median diastema, confirming midpalatal suture separation.

Phase II: Maxillary Protraction with Reverse Facemask

Following expansion, treatment progressed with reverse pull facemask to protract the maxilla anteriorly.

The orthopedic effect aimed to correct the skeletal Class III relationship by advancing the maxilla and improving the sagittal skeletal discrepancy.

Phase III: Comprehensive Orthodontic Treatment

After growth modification, the treatment plan includes placement of fixed orthodontic appliances (brackets) on both arches.

This stage will be directed toward final occlusal settlement, alignment, leveling, and achieving functional and esthetic

11/08/2025

Case Description
A 13-year-old growing patient presented with total maxillary constriction, involving both the anterior and posterior segments of the maxilla. The treatment was initiated with rapid maxillary expansion (RME) to address the transverse deficiency and create adequate maxillary arch width. Following the expansion phase, the patient was managed with Dallaire’s reverse pull facemask to achieve maxillary protraction and stimulate forward maxillary growth as part of a comprehensive growth modification approach.

The treatment is currently ongoing, with the focus remaining on growth modification to correct the underlying skeletal discrepancy. Upon completion of this phase, the patient is expected to receive comprehensive orthodontic appliance therapy to finalize alignment, occlusion, and functional outcomes.

09/08/2025

Case Description:
A 20-year-old male patient presented with chief complaints of difficulty in achieving proper bite and irregularly aligned lower teeth. Clinical and diagnostic examination revealed a constricted maxillary arch and an edge-to-edge anterior occlusal relationship, accompanied by crowding in the mandibular dental arch.

The treatment plan aimed to address the transverse maxillary deficiency and improve inter-arch relationships. Maxillary arch expansion was initiated as the first phase of treatment using an appropriate expansion protocol, maintained over a period of one year to achieve adequate transverse correction and arch coordination. This phase successfully improved the maxillary transverse width, providing space for proper occlusion and alignment.

At present, the case remains in progress, with the next stages focusing on detailed alignment, space management, and occlusal finishing to achieve stable functional and esthetic results

06/08/2025

Orthodontic Case Description

Patient: 12-year-old female
Chief Complaint: Facial esthetics concern and crossbite
Diagnosis:

Skeletal Relationship: Class III skeletal malocclusion with maxillary deficiency

Dental Relationship: Total anterior crossbite and bilateral constricted posterior crossbite

Other Findings: Unilateral impacted maxillary canine

Growth Stage: Prepubertal, indicating favorable timing for orthopedic intervention

Treatment Objectives:

Correct skeletal Class III relationship through maxillary advancement

Eliminate posterior and anterior crossbites

Expand the maxillary arch transversely

Improve facial esthetics and profile

Create space for the eruption of the impacted canine

Achieve a functional and stable occlusion

Treatment Plan:

Phase I: Growth modification using Rapid Palatal Expansion (RPE) combined with maxillary protraction using a reverse-pull facemask to stimulate forward growth of the maxilla and correct the transverse and sagittal discrepancies.

Phase II: Comprehensive fixed appliance therapy to align teeth, close spaces, and coordinate dental arches.

Impacted Canine Management: Space creation followed by spontaneous eruption monitoring and guidance. No surgical exposure was initially required.

Treatment Duration: Approximately 3 years

Outcome:

Successful orthopedic correction of Class III skeletal relationship

18/07/2025

Orthodontic Case Description

A 20-year-old male patient presented with congenital absence of the maxillary second premolars. Clinical and radiographic examination revealed a constricted maxillary arch both anteriorly and posteriorly, as well as rotated teeth and compromised occlusion. The patient exhibited a reduced overjet and overbite, contributing to functional and aesthetic concerns.

The treatment plan involved comprehensive fixed orthodontic therapy over a period of two years. The objectives were to correct the maxillary arch constriction, align the dentition, and establish proper occlusal relationships.

During treatment, maxillary expansion was achieved to address the transverse deficiency. Rotated teeth were successfully derotated, and appropriate space management allowed for optimal alignment of the dental arches. Positive overjet and overbite were established, resulting in improved occlusal function and facial aesthetics.

The treatment outcomes demonstrated significant improvement in both dental function and appearance, with stable results maintained at the conclusion of therapy.

05/07/2025

A 25-year-old female patient presented with multiple orthodontic concerns, including a constricted maxillary arch, generalized spacing in the mandibular arch, protrusion of the upper anterior teeth, and generalized spacing throughout the dentition. The patient also had a previously extracted upper left first permanent molar.

Initial Diagnosis:

Skeletal: Constriction of the maxillary arch, contributing to transverse discrepancy.

Dental: Proclination and protrusion of the maxillary anterior segment with generalized spacing; spacing also noted in the mandibular arch.

Other: Upper left first permanent molar missing, which affected the occlusal stability and required space management.

Treatment Objectives:

Expand the maxillary arch to correct the transverse constriction and create sufficient space for alignment.

Achieve proper alignment and leveling of both arches.

Close generalized spacing in both arches to improve esthetics and function.

Correct the upper incisor protrusion and establish proper incisor inclination and overjet/overbite relationships.

Manage the edentulous space of the missing upper left first permanent molar appropriately.

Achieve a stable, functional, and esthetic occlusion with good interarch coordination.

Treatment Plan:
The comprehensive treatment plan consisted of two major phases:

Phase I: Orthopedic expansion of the maxillary arch using an appropriate maxillary expander to correct the constriction and create space for proper tooth alignment.

Phase II: Comprehensive fixed orthodontic treatment using pre-adjusted edgewise appliances (brackets and archwires) to align and level both arches, close residual spaces, retract the upper anterior teeth, and coordinate the arches. Anchorage was planned and reinforced as needed to control unwanted tooth movement during space closure and retraction.

Treatment Progress and Outcome:
The maxillary expansion was successfully achieved, resulting in improved transverse dimension and arch form. Fixed appliances facilitated the alignment of both arches, closure of generalized spaces, and retraction of the protrusive upper incisors. Careful attention was given to the edentulous upper left molar site, maintaining appropriate space or preparing the area for future prosthetic rehabilitation if indicated.

The final occlusion demonstrated well-aligned arches with proper overjet and overbite, improved arch form, and a harmonious facial profile. The patient achieved significant esthetic and functional improvements, with the treatment objectives fully accomplished. Long-term retention was planned to maintain the achieved results.

If you’d like, I can also draft this as a clinical report or patient record note — just let me know!

20/05/2025

This case presented with a skeletal Class III malocclusion, accompanied by a dental Class III relationship and an anterior open bite of approximately 3 mm. The patient exhibited significant protrusion of the lower central incisors and canines, along with noticeable spacing in both arches. Comprehensive orthodontic treatment was carried out on both the upper and lower jaws to correct the malocclusion, align the dental arches, close the spacing, and achieve optimal functional and esthetic results.

19/05/2025

11/05/2025

Case Description:

An 18-year-old female patient presented with a severe skeletal Class III malocclusion, characterized by maxillary constriction and a skeletal open bite extending from the upper left second premolar to the upper right second premolar. The transverse discrepancy, combined with the sagittal imbalance, contributed to compromised occlusal function and esthetics.

Clinical evaluation and radiographic analysis confirmed the presence of a skeletal Class III base, associated with a narrow maxillary arch and anterior and lateral open bite, resulting in a lack of occlusal contact across the premolar and incisor region. The malocclusion exhibited both vertical and transverse components, complicating functional bite and facial balance.

A comprehensive fixed orthodontic treatment plan was undertaken, which extended over three years, incorporating musculoskeletal orthopedic approaches to address both the skeletal and dental components of the malocclusion. Treatment objectives included transverse expansion of the maxilla, correction of the skeletal open bite, and establishment of a stable and functional Class I occlusion.

Post-treatment results showed significant improvement in arch coordination, vertical overlap of anterior teeth, and overall facial harmony, highlighting the effectiveness of long-term interdisciplinary intervention in managing complex skeletal malocclusions.

08/05/2025

Case description

A 17-year-old male patient presented with an anterior crossbite involving four maxillary incisors. Clinical and radiographic examination confirmed a Class I molar relationship with anterior dental crossbite affecting both central and lateral incisors. The patient underwent comprehensive fixed orthodontic treatment aimed at correcting the anterior crossbite and achieving proper occlusal relationships.

Treatment involved the use of full fixed appliances in both arches to align and level the teeth, correct the crossbite, and establish optimal inter-arch coordination. Anchorage control and careful biomechanics were applied throughout the treatment to maintain Class I molar and canine relationships while transitioning the anterior teeth into correct overjet and overbite.

Following 24 months of active treatment, the case was successfully completed, achieving a stable Class I relationship in the incisor, canine, and molar regions with proper overbite and overjet, improved function, and enhanced esthetics.

05/03/2025

A 17-year-old female patient with Class II Division 1 malocclusion was treated using a camouflage approach with the extraction of the first premolars. The treatment aimed to achieve dental compensation, improve occlusion, and enhance facial esthetics without orthognathic surgery. Fixed orthodontic appliances were used to retract the upper anterior teeth, close extraction spaces, and establish a Class I canine relationship. The total treatment duration was two years, resulting in improved dental alignment, overjet reduction, and a balanced profile.