Dental student extraction for braces?

[sddat]

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I'm not asking for diagnosis advice..just want to see your experiences with extractions/ortho.

I'm in dental school and need an extraction (upper premolar) to get braces. My teeth are not super crowded. Just need more room. Has anyone seen any cases where the pt should not have had 1 premolar removed? I am worried about this extraction changing my VDO/ facial position. It's a permanent decision and I cannot make up my mind.

I'm thinking my face could look more sunken in without my crowding that I'm used to..THANKS!

 

[wigglytooth]

I have not seen the cases first hand, but I'm in braces myself and did not do the premolar extractions b/c I was advised that my already tiny upper lip would sink in. Instead of exo's, TADs were used as anchors as they distalized my teeth to create the space needed. Taking over two years, so still waiting for the final result on profile etc. So, I guess to answer your question, profile is a concern all around when you take out teeth.

You really need to go back to whoever treatment planned your case and see if there are any other options for your case besides Exo's and advice on how your profile may change with whatever option. Sounds like you did not get all your questions answered when you were worked up.

 

[charlestweed]

If you have class II molar/canine on the side that the orthodontist wants to extract your tooth and your upper dental midline does not match your facial midline (ie upper dental midline is off to the opposite side), then it is a good idea to extract one premolar.

The average premolar width is about 7-9mm. 2-3mm will be used to correct the anterior crowding. 2-3mm will be lost due to posterior anchorage loss. And the remaining 3-4 mm will be used to bring the canine to ideal class I relationship and to retract upper incisors to ideal overjet. It won't be a 1:1 relationship… if the upper incisors are brought back 3 mm, the upper lip will go back less than 3mm. In short, the facial profile change is insignificant after the extraction of an upper premolar.

Without extraction, the ortho may not be able to give you an ideal occlusion at the end of the treatment. Since most ortho offices don't charge consultation fee, you should see another ortho for a second opinion.

 

[tinman831]

Sorry but this is a medical advice question. Consult with your orthodontist with your concerns. Closing thread.