Extraction of teeth in orthodontics

Question 1

Extraction of teeth in orthodontics

Extraction in orthodontics

Answer 1

prophylactic measure in cases affecting normal
development of dental arch and
occlusion

Question 2

Extraction of teeth in orthodontics

Indications for extractions in orthodontics

Answer 2

• Heredity of jaw and teeth size=> difficult to align
• Arch length- tooth material discrepancy
• Correction of sagittal interarch
  relationship
• Impacted teeth
• anchorage requirements
• Hypoplastic, heavily restored or carious teeth should
  generally be removed in preference to healthy teeth

Question 3

Extraction of teeth in orthodontics

Upper central incisors extraction indications

Answer 3

• No extractions=>
• They determine symmetry of dentition

Exceptions include poor long-term prognosis, traumas, and severe periodontal involvement.

Question 4

Extraction of teeth in orthodontics

Upper lateral incisors extraction indications

Answer 4

• No extractions=>
• Esthetics in frontal segment will be affected.

Exceptions include unilateral hypodontia, retention of one incisor, and canines disguised as lateral incisors.

Question 5

Extraction of teeth in orthodontics

Upper canines extraction indications

Answer 5

• Do not extract=>
• Rarely considered unless very ectopic

Canines are important for occlusal guidance and facial expressions.

Question 6

Extraction of teeth in orthodontics

Upper first premolars extraction indications

Answer 6

• Most commonly extracted=>
• Due to their position in the arch

Ideal for relief of anterior and posterior crowding.

Question 7

Extraction of teeth in orthodontics

Upper second premolars extraction indications

Answer 7

Preferred for extraction if impacted or due to severe crowding.

Consider if palatally erupted without space or skeletal discrepancies.

Question 8

Extraction of teeth in orthodontics

Upper first molars extraction indications

Answer 8

Extraction is strictly individual based on condition.

Consider if heavily restored, devitalized, or in case of open bite.

Question 9

Extraction of teeth in orthodontics

Upper second molars extraction indications

Answer 9

Extraction is strictly individual based on condition.

Consider if devitalized or with periapical changes.

Question 10

Extraction of teeth in orthodontics

Indications for extraction of lower incisors

Answer 10

• Extraction should be avoided in general
• It is strictly individual in cases of:
• Tooth-to-tooth discrepancies
• Grossly displaced from arch form
• Edge-to-edge occlusion and crowded frontal teeth
• Vestibular inclination with recessions

Question 11

Extraction of teeth in orthodontics

Indications for extracting lower canines

Answer 11

• Do not extract=>
• Have longest root and are key for prosthetic replacement

Exception: Ectopically erupted or unfavorable impacted canines with horizontal position and completed root development.

Question 12

Extraction of teeth in orthodontics

Indications for lower first premolar extraction

Answer 12

• Most commonly extracted=>
• To relieve crowding and proclination=>
• Especially in cases with class III skeletal discrepancy

Question 13

Extraction of teeth in orthodontics

Indications for extracting lower second premolars

Answer 13

• Preferred for extraction in cases of:
• Erupted lingually without space in the arch (blocked)
• Skeletal discrepancies

Question 14

Extraction of teeth in orthodontics

Indications for lower first molar extraction

Answer 14

• Play a key role in occlusion
• Extraction is strictly individual in cases when:
• Destroyed
• Non-vital teeth
• With periapical changes
• In case of open bite (hyperdivergent type)

Preferable to extract prior to the eruption of second premolars.

Question 15

Extraction of teeth in orthodontics

Indications for lower second molar extraction

Answer 15

• Extraction is strictly individual and indicated in cases when:
• Destroyed
• Favorable eruption of third molars
• Need for distalization of first permanent molars

Question 16

Extraction of teeth in orthodontics

Serial extractions

Answer 16

• Planned removal of certain deciduous and permanent teeth in mixed dentitions=>
• w/ dento-alveolar disproportions

Question 17

Extraction of teeth in orthodontics

Indications for serial extraction in cases with Class I malocclusion

Answer 17

1. Macrodontia (SI – above 35 mm, Si – above 27 mm)
2. Space required for the lateral incisor – more than 6 mm deficiency with resorption of the primary canine
3. Hyperdivergent type of growth – open bite or edge-to-edge occlusion.

Question 18

Extraction of teeth in orthodontics

Contraindications for serial extractions

Answer 18

1. Deep bite - extractions in the lower arch should be undertaken with caution due to potential increase in overbite.
2. Hypodivergent type of growth.

Question 19

Extraction of teeth in orthodontics

Disadvantages of serial extractions

Answer 19

1. Traumatizing the child
2. Fixed appliances after a long period of follow-up
3. Decrease arch length
4. Increase in overbite.

Question 20

Extraction of teeth in orthodontics

Phases of serial extractions

Answer 20

• When? – after eruption of permanent incisors.
• I phase – extraction of primary canine to relieve space in the frontal segment.
• II phase – extraction of first primary molars to accelerate eruption of first premolars.
• III phase – extraction of first premolars to relieve space for eruption of permanent canines.

Question 21

Extraction of teeth in orthodontics

If second premolars tend to erupt before permanent canines

Serial extractions

Answer 21

• Extract primary second molars first=>
• Encourage eruption of second premolars, then extract first premolars.

Question 22

Extraction of teeth in orthodontics

If permanent canines tend to erupt before second premolars

Serial extractions

Answer 22

• Extract first premolars followed by extraction of second primary molars=>
• To allow distal migration of erupting permanent canines.