Class I malocclusions with severe crowding and tooth size discrepancies may be successfully treated orthodontically with extraction therapy, and co-management with other specialists. Correction of the discrepancies will optimize occlusal result (overjet, overbite, midline shift, and smile esthetics). This is a case of a 19-year-old male with severe crowding in upper and lower teeth and peg lateral incisor. The patient had malocclusion Class I. This case was treated comprehensively and successfully using fixed orthodontic appliances with extraction of four premolars, and veneer composite for peg lateral incisor with the help of a conservative dentist at the end of orthodontic treatment.
Malocclusion, Angle Class I

Class I malocclusions with severe crowding and tooth size discrepancies may be successfully treated orthodontically with extraction therapy, and co-management with other specialists. Correction of the discrepancies will optimize occlusal result (overjet, overbite, midline shift, and smile esthetics). This is a case of a 19-year-old male with severe crowding in upper and lower teeth and peg lateral incisor. The patient had malocclusion Class I. This case was treated comprehensively and successfully using fixed orthodontic appliances with extraction of four premolars, and veneer composite for peg lateral incisor with the help of a conservative dentist at the end of orthodontic treatment.