Re: extracting primary teeth in crowded cases?
« Reply #1 on: May 28, 2012, 09:36:46 AM »
speaking to orhtodontits never hurts, but it's a good thing if you know what you're talking about
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
- 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.