Nbhagan Posts: 182 extracting primary teeth in crowded cases?



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nbhagan

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extracting primary teeth in crowded cases?

« on: May 25, 2012, 08:29:12 AM »



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Orthodontists sometimes send patients to have primary teeth removed for example c's in a potential crowded case. is this a form of serial extraction? this does not seem to be emphasized  in the POS system.

Of course this does not create space or change the maxilla/mandibular relationship does it serve any purpose?  one orthodontist said that it relieves anterior crowing moving it to the posterior which is easier to treat. Another orthodontist was totally against it.

Should i stop speaking to orthodontists?  grin

Nathan








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dloew

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Re: extracting primary teeth in crowded cases?

« Reply #1 on: May 28, 2012, 09:36:46 AM »



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Hi Nathan,

speaking to orhtodontits never hurts, but it's a good thing if you know what you're talking about  wink

Serial extraction normaly is done in a child aged 7-9 years. You can predict the final arch length by looking at the model meassuring "mixed dentition analysis" and make a decision for serial extraction after having considerd esthetics, inclination of the front teeth, skelettal patterns, cooperation and all the other things a full diagnosis includes.

Teeth to extract in Serial extraction:
- Lower C’s allows alignment of incisors
- Lower D’s speeds eruption of first bicuspid get 4 into arch before 3
- Upper C’s allows alignment or better eruption upper 2’s

POS-Version:


- Lower 4’s in superior eruption to lower 3’s
- Key feature is a continual reevaluation and no extraction of Unerupted teeth.
- Step1;extract lower Cs,Ds,,upper C’s if reasoning fits the case. Wait for eruption of 4’s with 3-6 month observation visits, lower lingual arch if you want to maintain incisor position.
- Step 2;(eruption of 4’s complete) New records to confirm diagnosis. Could change mind to non extraction, check!, prevents over extraction. Extract 4’s if diagnosis correct
- Step 3;(full eruption) New records to plan anchorage and space closure. Complete phase 2,final records

Serial extraction criteria:


- Class 1 can do in class 2 if patient willing to wear appliance e.g. headgear
- Severe crowding =or greater than 8mm
- Lower 4 erupts ahead of lower 3
- Nice facial profile

Problems with serial extraction:


- Lower incisors drift lingual after lower C’s extracted
- Bite deepens
- Risk of over extraction dish face
- Parents don’t like extractions
- Extraction space used to correct class 2 or protrusion is lost

I hope this was helpful.



Regards
dloew








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