Report on Orthodontics

1. Serial Extraction
HISTORICAL PERSPECTIVE
JOSEPH RUSSELL N. GORDA

2. ROBERT BUNON
(1743)
first to advise the extraction of
primary teeth to achieve better
alignment of permanent teeth in his
work Diseases of Teeth
Father of Pediatric Dentistry
French

3. • Bourdet (1757), Hunter (1771), Robinson (1846)
and Harris (1885)
• advocated removal of primary canines and premolars
when permanent incisors were crowded

4. Kjellgren (1929)
First coined the term Serial
Extraction

5. Nance (1970)
Popularized the procedure.
Father of Serial Extraction
Technique

6. • Although popular, the term serial extraction does not
state the importance of thorough knowledge of growth
and development, comprehensive analysis based on
investigative records required to execute the procedure
properly and thus may be misleading

7. Hotz (1970)
Argued against the term Serial
Extraction.
Preferred the term Guidance of
Eruption (a.k.a. Guided extraction /
Guidance of Occlusion)

8. Serial Extraction: INDICATIONS

9. Serial Extraction
• primarily in developing class I malocclusions with
moderate to severe arch length-tooth material
discrepancy with resultant crowding of teeth
• gives best results in patients with ideal orthognathic
profile and in whom all the components of
stomatognathic system (i.e. neuromuscular envelop,
basal jaw bones and teeth) are in balance with good
facial harmony.

10. INDICATIONS
• Class I maloclussion with ideal orthognathic facial profile
and good neuromuscular balance.
• Severe arch length-tooth material discrepancy of 10 mm
or more in the arch.

11. Arch length deficiency as compared to total
material can be indicated by the following feature:
• Absence of developmental / physiologic spacing in deciduous dentition
• premature exfoliation of deciduous canines especially in the lower arch
• Abnormal root resorption pattern of deciduous canines-radiographic
examination reveals a crescent pattern or resorption on the medial side of
primary canine roots.
• Midline shift due to displacement of lateral incisors following premature
loss of unilateral deciduous canine
• Proclination of permanent upper and lower incisore associated with
crowding
• Lingual eruption of upper lateral incisors

12. • Extreme labial displacement of lower incisors
• Gingival recession in relation to labially placed lower incisor
teeth
• Abnormal exfoliation sequence of primary teeth
• Altered eruption sequence of primary teeth
• Ankylosis of primary teeth
• Ectopic eruption of permanent teeth especially that of upper
canines. Upper canines erupt after the emergence of one or
both the premolars and thus tend to assumes extreme
buccal or palatal position when there is lack of space in the
arch