2. Extraction-Painless removal of teeth from its socket
It is one of the most common methods of gaining space
in the arch
Introduction
3. HISTORY
1771,John hunter recognized the role of extraction in
orthodontics in his book natural history of the teeth
The ‘Great extraction controversy of 1920’s’-Angle vs
Case
1940’s charles Tweed and Raymond Begg
4. THE NEED FOR EXTRACTION
ARCH LENGTH TOOTH MATERIAL DISCREPANCY
CORRECTION OF SAGGITAL INTERARCH RELATIONSHIP
ABNORMAL SIZE AND FORM OF TEETH
SKELETAL JAW MALRELATIONS
5. DIFFERENT EXTRACTION
PROCEDURES
BALANCING EXTACTIONS;Removal of a tooth on the
opposite side of the same arch (although not necessarily
the antimere) in order to preserve symmetry
COMPENSATING EXTRACTIONS Removal of the
equivalent tooth in the opposite arch to maintain buccal
occlusion.compensating extractions preserve interarch
arch relationship by allowing the posterior teeth to drift
forward together
6. Enforced extractions;These extractions are carried out
because they are necessary as in the case of grossly
decayed teeth,poor periodontal status ,fractured tooth
impacted tooth etc.
Wikinson extraction ;Extraction of all four first molars
between the age of 8.5 and 9 yrs
8. The choice of teeth for
extraction
Maxillary incisors-
An unfavourably impacted upper incisor that cannot be
brought to normal occlusion
Labially/lingually blocked out lateral incisor with good
contact between the central incisor and canine can be
extracted
Grossly carious incisor that cannot be restored
Trauma/irreperable damage to incisors by fracture
9. Mandibular incisors
Extraction of lower incisor should be avoided
Narrowing of lower inter canine width
Retroclination of lower incisor
Deep bite
Reappearance of crowding
Upper anterior crowding
10. Indications
When one incisor is completely excluded from the arch
with satisfactory approximal contacts between other
incisors
Poor prognosis as in case of trauma,caries,bone loss etc
Fan shaped flaring of the lower incisor crowns-it is
difficult to correct such conditions by extractions
further back in the arch
11. In mild classIII incisor relation with an acceptable upper
arch and lower incisor crowding , a lower incisor may be
extracted to achieve normal overjet,overbite and to
relieve crowding
12. CANINES
Not frequently extracted
- flattening of face
- altered facial balance
- change in expression
-contact between the premolar and lateral incisor is
rarely satisfactory
13. Indications
Unfavourably impacted canines or canines that have
erupted in unusual locations may have to be removed
A canine that is completely out of the arch with
reasonably good contact between the lateral incisor and
first premolar
14. Deciduous canine may be extracted as a part of serial
extraction procedure
15. First premolars
Most commonly extracted teeth
Location-space gained can be utilized for correction
both in the anterior as well as the posterior region
The contact that results between the canine and second
premolar is satisfactory
16. The extraction of the first premolar leaves behind a
posterior segment that offers adequate anchorage for
the retraction of the six anterior teeth
17. Indications
Teeth of choice for extraction to relieve moderate to
severe crowding of the upper or lower arch
The first premolars are extracted for the correction
moderate to severe anterior proclination as in a classII
div1 malocclusion or a classI bimaxillary protrusion
18. Extraction of second
premolars
Indications-
To treat mild anterior crowding. The remaining space
can be closed by controlled mesial movement of the
molars.
If extractions are to be undertaken in open bite cases,
it is preferable to extract the second premolars as their
extractions encourages deepening of the bite.
19. Grossly carious second premolars.
Completely out of the arch erupted second premolars.
20. Extraction of first permanent
molars.
Doesn’t give adequate space in the incisor region.
Deepening of the bite
Mastication may be affected.
22. Extraction of second molars
To prevent third molar impaction.
To relieve impacton of second premolars.
Lower incisor crowding.
To enable distalization of first molars.
Open bite cases.
