---
title: When it Comes to Orthodontics, Diagnosis is the Key - A Case Study by Dr. Kishore
description: Dr. Kaushal Kishore diagnoses and treats a patient with crowing that preferred a non- extraction treatment plan.
image: https://blog.smilestream.com/hubfs/Before%20Kishore.png
---

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# When it Comes to Orthodontics, Diagnosis is the Key - A Case Study by Dr. Kishore

Posted by [POS Course Adviser](https://blog.smilestream.com/author/pos-course-adviser) on 4/20/22 2:48 PM

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*As part of our Consultant Spotlight this month, learn how POS Consultant and Instructor, Dr. Kaushal Kishore, treats a young man afraid to smile.*

**

![Before Kishore](https://blog.smilestream.com/hs-fs/hubfs/Before%20Kishore.png?width=734&name=Before%20Kishore.png)

**My patient**

Summary:

- 27- year- old
- Not happy with facial appearance
- Advised to get extraction so avoided treatment
- 20-month treatment duration

The patient was not happy about the way his teeth looked and always hesitated to smile when posing for photographs. His confidence was very low and he knew it had something to do with his smile. He visited several dentists who examined him and gave him the option of orthodontics with extraction of bicuspids. He was too terrified to extract his teeth and would always turn down treatment plans.

**Evaluation & Diagnosis**

When we examined him clinically, we saw that his profile was straight and he could tolerate some advancement. He had 9mm of crowding in the lower arch and 6mm of crowding in the upper arch. He had 4mm class 2 on the right canines and class 1 on the left canine.

![Picture7](https://blog.smilestream.com/hs-fs/hubfs/Picture7.jpg?width=250&name=Picture7.jpg)![Picture8](https://blog.smilestream.com/hs-fs/hubfs/Picture8.jpg?width=250&name=Picture8.jpg)

![Picture9](https://blog.smilestream.com/hs-fs/hubfs/Picture9.jpg?width=250&name=Picture9.jpg)![Picture10](https://blog.smilestream.com/hs-fs/hubfs/Picture10.jpg?width=250&name=Picture10.jpg)

![Picture12](https://blog.smilestream.com/hs-fs/hubfs/Picture12.jpg?width=250&name=Picture12.jpg)![Picture11](https://blog.smilestream.com/hs-fs/hubfs/Picture11.jpg?width=250&name=Picture11.jpg)

**Treatment Decision**

Like every single case in our practice, we did the entire workup on the SmileStream software and made VTOs for extraction and non-extraction plans. The non-extraction VTO showed some advancement which his profile could tolerate and we could also use some labial root torque brackets to upright the tooth and reduce proclination. Based on our diagnosis, non-extraction was our treatment decision.

**Case Outcome**

His treatment went well and achieved excellent results. It was a very joyful day when we debanded him. All of us were so happy with the outcome. Needless to say that he was jubilant about it and still to this day shares his selfies with us and thanks us for the change that we brought to his smile, his confidence, and ultimately his life.

If you have the right combination of tools for treatment and diagnosis, results are very predictable

Your smile forms 65% of your facial appearance and is a big factor in a lot of people's self-esteem. So let’s get our diagnosis right and create everlasting smiles.

![After Kishore](https://blog.smilestream.com/hs-fs/hubfs/After%20Kishore.png?width=734&name=After%20Kishore.png)

 Topics: [Case Study](https://blog.smilestream.com/topic/case-study), [Adult Orthodontics](https://blog.smilestream.com/topic/adult-orthodontics), [Orthodontics](https://blog.smilestream.com/topic/orthodontics)

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