When removing lower 2nd molar?
A- Occlusal plane perpendicular to floor
B- Buccolingual direction to dilate socket***
C- Mesial then lingual.
MOLAR EXTRACTIONS IN ORTHODONTICS:
- The vast majority of cases treated in orthodontics do not require extraction of teeth to make corrections.
- When extractions are indicated, the premolars (first and / or second) are the teeth most often chosen to provide space for alignment of other teeth (in more than 80% of extraction cases).
- However other teeth can also be extracted under certain particular conditions.
- This section is devoted to cases where permanent (permanent) molars have been extracted as part of an orthodontic treatment not because the indications for such extractions are frequent but to explain why teeth as big and located as far into the dental arch may need to be extracted.
- It is rare to use molar extraction to correct malocclusions but this is indicated in certain situations.
- Some indications where molars can be extracted: very damaged teeth, large gaps, included teeth that do not come out, important need of space to move other teeth, etc.
- Molar extraction cases are usually more difficult to treat and the treatment lasts longer and may be more expensive than similar treatment where the molars are in place or if other teeth (premolars) have been selected for treatment. extraction, but if the choice to extract one or more molars was dictated by the poor quality of these teeth (caries, root canal treatment, fractures, periodontal problems, etc.) the savings achieved by not having to restore these problematic teeth (crowns, root canal treatment, dental implant) can often "pay" or compensate for much or even all of the costs of orthodontic treatment. The following case is an example.
A- Occlusal plane perpendicular to floor
B- Buccolingual direction to dilate socket***
C- Mesial then lingual.
MOLAR EXTRACTIONS IN ORTHODONTICS:
- The vast majority of cases treated in orthodontics do not require extraction of teeth to make corrections.
- When extractions are indicated, the premolars (first and / or second) are the teeth most often chosen to provide space for alignment of other teeth (in more than 80% of extraction cases).
- However other teeth can also be extracted under certain particular conditions.
- This section is devoted to cases where permanent (permanent) molars have been extracted as part of an orthodontic treatment not because the indications for such extractions are frequent but to explain why teeth as big and located as far into the dental arch may need to be extracted.
- It is rare to use molar extraction to correct malocclusions but this is indicated in certain situations.
- Some indications where molars can be extracted: very damaged teeth, large gaps, included teeth that do not come out, important need of space to move other teeth, etc.
- Molar extraction cases are usually more difficult to treat and the treatment lasts longer and may be more expensive than similar treatment where the molars are in place or if other teeth (premolars) have been selected for treatment. extraction, but if the choice to extract one or more molars was dictated by the poor quality of these teeth (caries, root canal treatment, fractures, periodontal problems, etc.) the savings achieved by not having to restore these problematic teeth (crowns, root canal treatment, dental implant) can often "pay" or compensate for much or even all of the costs of orthodontic treatment. The following case is an example.
Characteristics of malocclusion:
- 18-year-old girl with an imbalance between the jaws (upper jaw narrower and retracted than the lower one) (Class III).
- Lack of space, lack of contact between several top and bottom teeth.
- Lack of overhang between the top teeth and those of the bottom at the front.
- Several severely damaged teeth; the first 4 molars are either decayed, fractured or have extensive repairs (amalgam) - (red arrows in the picture).
Considerations:
- Given the poor condition of the first molars, we opted to extract and close the spaces created by these extractions.
- This approach is unusual but very beneficial in this case. This saved the patient significant dental expenses that would have been required for root canal treatments, repairs, crowns, etc. In fact, in this specific case, the saving made by the patient by extracting the 4 molars covered more than the costs of extraction and orthodontics!
- The presence of an imbalance between the jaws would have required the use of an expansion device to expand the upper jaw with a more "traditional" approach. However, in this case, the corrections were made without an expansion device or surgery.
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Oral Surgery