Julia presented at 11 years of age with a crowded dentition. She still had some baby (deciduous) teeth present.There was crowding present with rotation of the front teeth and a slight prominence (overjet) of the upper incisors.

This stage in the development of the dentition was an ideal time to begin treatment with a non-extraction approach

An upper removable appliance called a "Nudger" was used, along with a lower lip bumper.
Working together, these two appliances created more space for the teeth to be aligned in the dental arches.This picture shows a second Nudger.
After 6 months of treatment, space is beginning to appear in the upper arch as the first molars are moved back and out.

Once the removable appliances had finished their work and all the adult teeth had erupted, there was sufficient space for the alignment of the teeth.

It was time to use a fixed brace to complete the case.

After seven months of alignment with the fixed braces, all was looking good.