CASE REPORT MANAGING A TRANSVERSE CONSTRICTION COMPOUNDED WITH A LONG FACE IN A YOUNG ADULT: A Clinical Case Report By Juan C. Echeverri, DDS, DAOS, and Elsa A. Echeverri, DDS FAAPD O Fig. 1: Shown are initial clinical images of a 13.5-year-old patient with a long, thin face compatible with a dolichocephalic growth pattern, additional to maxillary and mandibular incisor crowding. The maxillary arch has transverse constriction with crowding of the central and lateral incisors. The mandible presents with lingualized molars and bicuspids, creating a strong curve of Wilson. The mandibular canines and incisors are lingualized and crowded. The maxillary second molars and canines are delayed in their eruption pattern. rthodontic treatment of young adults can be challenging due to altered dentition caused by modified growth and dental eruption patterns, compounded with habits or muscle imbalances, either by altered tongue or swallow-ing patterns. Teeth may be congeni-tally missing or missing due to many other factors, such as trauma, dental decay or pulp necrosis. These dental and skeletal conditions may affect function and/or alter the facial presentation of the individ-ual, creating social awkwardness. This case report explores a patient originally treated as a young adolescent, then partially treated as an older teenager, and finally treated as a young adult who embraced the treatment to achieve resolution of his dental and orthodontic needs. The final phase of treatment was unique, as the authors custom designed an auxiliary appliance to address both transverse development and intru-sion while managing the rest of his dentition. 18 Fall 2025 JAOS
Journal of the American Orthodontic Society Fall 2025: Page 18
