Patients who have severe crowding that requires four premolars extraction will be treated in this study. The efficacy and effectiveness of in-house clear aligners therapy compared with vestibular fixed appliances in the treatment of severe crowding malocclusion cases requiring the extraction of first premolars will be evaluated using Little's irregularity index (LII), Peer assessment rating index (PAR), and treatment duration. There are two groups: First group (Experimental): the patients in this group will be treated using clear aligners. Second group (Control): the patients in this group will be treated using fixed appliances.
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Change in PAR index
Timeframe: T0: one day before the commencement of treatment. T1: one day following the end of treatment
Changes in Little's irregularity index
Timeframe: T0: one day before the commencement of treatment. T1: one day following the end of treatment