• Save
Therapeutic Extraction
Upcoming SlideShare
Loading in...5
×
 

Therapeutic Extraction

on

  • 619 views

Introduction to Orthodontics

Introduction to Orthodontics
Fifth Year

Statistics

Views

Total Views
619
Views on SlideShare
619
Embed Views
0

Actions

Likes
0
Downloads
0
Comments
2

0 Embeds 0

No embeds

Accessibility

Upload Details

Uploaded via as Adobe PDF

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

Therapeutic Extraction Therapeutic Extraction Presentation Transcript

  • Therapeutic Extraction
  • Outline  Indications: ِِTo relieve crowding. To correct anteroposterior dental arch relationship. To improve facial esthetics.  Consideration in Therapeutic Extraction: Condition of the teeth. Position of the teeth. Degree and position of the crowding. April 28, 2012 Dr. Ahmed Basyouni 2
  • Outline  Choice of teeth for Extraction: Incisors: Canines: First premolars: Second premolars: First permanent molar: Second permanent molar: Third molar: April 28, 2012 Dr. Ahmed Basyouni 3
  • Indications A. To relieve crowding B. To correct anteroposterior dental arch relationship C. To improve facial esthetics. April 28, 2012 Dr. Ahmed Basyouni 4
  • A. To relieve crowding: If the dentition is too large to fit in the dental arch without irregularity, it is necessary to reduce the dentition size by extraction of teeth. It is not normally accepted to increase size of the dental arch, except in certain cases, because this would not be tolerated by oral musculature. April 28, 2012 Dr. Ahmed Basyouni 5
  • A. To relieve crowding: CLASS I EXTRACTION CASE WITH SEVERE CROWDING April 28, 2012 Dr. Ahmed Basyouni 6
  • B. Extraction for correction anteroposterior dental arch relationship: It is frequently necessary to remove teeth to give space for correction of discrepancies in arch relationship. For example, in Class II relationship, when upp. Arch is too far forward in relation to lower. The upp. anterior segment is moved back during treatment, after extraction to provide space for retraction of the anterior teeth. April 28, 2012 Dr. Ahmed Basyouni 7
  • B. Extraction for correction anteroposterior dental arch relationship: CLASS II, div. 1 subdivision right, MALOCCLUSION EXTRACTION CASE EXTRACTION OF UPPER FIRST PREMOLARS + LOWER SECOND PREMOLARS April 28, 2012 Dr. Ahmed Basyouni 8
  • C. Extraction for improvement of facial esthetics: It is usually done in cases of Class I Angle’s malocclusion with bimaxillary dentoalveolar prognathism. April 28, 2012 Dr. Ahmed Basyouni 9
  • C. Extraction for improvement of facial esthetics: CLASS I EXTRACTION CASE CROWDING DENTAL PROTRUSION April 28, 2012 Dr. Ahmed Basyouni 10
  • Consideration in Therapeutic Extraction    Condition of the teeth Position of the teeth Degree and position of the crowding April 28, 2012 Dr. Ahmed Basyouni 11
  •  Condition of the teeth: Fractured, hypoplastic, badly carious teeth and teeth with extensive restoration, all more favourable for extraction than sound healthy teeth. Tooth condition is the overriding factor, even treatment would be more difficult or prolonged. April 28, 2012 Dr. Ahmed Basyouni 12
  •  Position of the teeth: Grossly malposed teeth would be difficult to align are often the teeth of choice for extraction. In particular, position of the apex of the tooth must be considered, as it is usually more difficult to move the apex than to move the crown. April 28, 2012 Dr. Ahmed Basyouni 13
  •  Degree and position of the crowding: If crowding is located in one part of the arch, it would be more favourable, if extraction carried out in that part, rather than in remote uncrowded part. However, this principle is not considered a rule, e.g. crowding of the incisors is usually relieved by extraction of premolars. This usually gives more pleasing final appearance, and occlusal balance than removal of the incisors. April 28, 2012 Dr. Ahmed Basyouni 14
  • Choice of teeth for Extraction  Incisors: 1. Upper central incisors are rarely extracted for relief of crowding, unless their condition is the overriding factor (severely fractured). In such cases, lateral incisors may be aligned and crowned to simulate missing central incisors. The usual reason for removing upper lateral incisors are: a) Severe malposition of the tooth. b) Malformation of the tooth. April 28, 2012 Dr. Ahmed Basyouni 15
  • Choice of teeth for Extraction Incisors: 2. Lower incisors, as a rule removal of a lower incisor from an imbricated arch is to be avoided as this will result in increased curve of spee, over-eruption of anterior teeth and decrease of the inter-canine width. But, extraction of a lower incisor can be made if it is the only tooth outside the arch alignment and / or there is gum stripping and lacking of supporting alveolar bone around the tooth. April 28, 2012 Dr. Ahmed Basyouni 16
  • Choice of teeth for Extraction Incisors: April 28, 2012 Dr. Ahmed Basyouni 17
  •  Canines: Upper canine is removed only, if it is severely malpositioned or impacted. This may be developmental malposition or due to severe crowding. Position of the apex is the prime consideration. April 28, 2012 Dr. Ahmed Basyouni 18
  • April 28, 2012 Dr. Ahmed Basyouni 19
  •  First premolars: The first premolar is the tooth most commonly removed for relief of crowding. It is positioned near the center of each quadrant of the dental arch and is therefore near the site of crowding. Another important factor, second premolar has same shape and makes a similar contact with the canine. So, loss of the first premolar does not affect quality of contact between teeth. April 28, 2012 Dr. Ahmed Basyouni 20
  • First premolars: April 28, 2012 Dr. Ahmed Basyouni 21
  •  Second premolars: Removal of second premolar for relief of crowding is usually undertaken when the tooth is itself malpositioned through crowding. As it erupts after first premolar and first permanent molar, it may be completely blocked out from the dental arch. April 28, 2012 Dr. Ahmed Basyouni 22
  • Second premolars: Class II, Extraction treatment EXTRACTION OF UPPER FIRST PREMOLARS + LOWER SECOND PREMOLARS April 28, 2012 Dr. Ahmed Basyouni 23
  •  First permanent molar: Not usually the tooth of choice for extraction. If extraction is necessary due to caries, two situations exist which control timing of the extraction: a) if no space is required for alignment of the anterior segment, extraction should be carried out before second molar erupts. b) if space is required for alignment of the anterior segment, extraction should be carried out after eruption of the second molar. April 28, 2012 Dr. Ahmed Basyouni 24
  • First permanent molar: April 28, 2012 Dr. Ahmed Basyouni 25
  •  Second permanent molar: The second permanent molar is not often removed for the relief of crowding. It is sometimes, removed when first permanent molars have moved forward leaving insufficient space for eruption of second premolars. Removal of second molar will allow distal movement of first molar to increase premolar space. In general, extraction of second molar does not allow much spontaneous relief of crowding but may relieve third molar impaction if third molar is not severely inclined mesially. April 28, 2012 Dr. Ahmed Basyouni 26
  •  Third molar: Extraction of third molars has been advocated by some orthodontists to prevent or relief potential crowding in the dental arch specially in the incisor area. April 28, 2012 Dr. Ahmed Basyouni 27
  • Serial Extraction  Indication: Class I malocclusion with severe crowding of upper & lower permanent incisors in the mixed dentition stage. April 28, 2012 Dr. Ahmed Basyouni 28
  • Serial Extraction  Contraindication: 1. Congenital missing second premolars. 2. Extensive caries of permanent first molars. April 28, 2012 Dr. Ahmed Basyouni 29
  • Serial Extraction Timing  At 8 years old: Extract C C For eruption 2 2 April 28, 2012 C C 2 2 Dr. Ahmed Basyouni 30
  • Serial Extraction  At 9 years old: Extract D D 3 3 For eruption April 28, 2012 Dr. Ahmed Basyouni 31
  • Serial Extraction  At 10 ½ years old: Extract D For eruption 4 April 28, 2012 D 4 Dr. Ahmed Basyouni 32
  • Serial Extraction  At 11 years old: Extract E E For eruption 5 4 April 28, 2012 E E 5 4 Dr. Ahmed Basyouni 33
  • Serial Extraction  At 11 ½ years old: Extract 4 4 For eruption 4 4 3 3 5 April 28, 2012 5 Dr. Ahmed Basyouni 34
  • Summary  Indications: A. To relieve crowding B. To correct anteroposterior dental arch relationship C. To improve facial esthetics.  Consideration in Therapeutic Extraction: Condition of the teeth Position of the teeth Degree and position of the crowding April 28, 2012 Dr. Ahmed Basyouni 35
  • Summary  Choice of teeth for Extraction: Incisors: Canines: First premolars: Second premolars: First permanent molar: Second permanent molar: Third molar: April 28, 2012 Dr. Ahmed Basyouni 36
  • Serial Extraction    Indication: Contraindication: Timing: April 28, 2012 Dr. Ahmed Basyouni 37
  • April 28, 2012 Dr. Ahmed Basyouni 38