An orthodontic treatment is usually performed because the patient wants to solve dental crowding. After an evaluation by the orthodontist, it is determined whether the patient needs to perform dental extractions or not, the orthodontist will take into account the age of the patient, the skeletal situation, perform a dental and soft tissue analysis, and take into account the periodontal situation and bone level.
Dental extractions within orthodontic treatment are indicated in some cases after radiographic analysis, study models and photographs. Extractions have to be performed in specific cases, and are carried out with the aim of creating spaces to be able to align the rest of the teeth. Dental extractions are performed if there is a great lack of space that cannot be corrected with other means, such as; expanding the arches, performing interproximal wear, stripping, among others, thanks to the extraction of one or two teeth per arch we could achieve enough space to correctly align the rest of the teeth inside the arcade.
When are dental extractions usually performed?
- When there is lack of space; The teeth are extracted to gain space and to be able to correctly align the other teeth within the dental arch.
- Facial aesthetics: To be able to improve both functionally and aesthetically the relationship of the jaws, to be able to correctly coordinate the upper and lower arches. In addition, we can achieve retraction of the lip in order to improve its appearance (a premolar can be extracted).
- In biprotrusion situation: When both the upper and lower jaw aspect are advanced, a facial aesthetic is created with a lower 1/3 of the face more prominent than the rest. By extracting the upper and lower premolars, the anterior sectors can be retracted backwards in order to achieve a better facial harmony and establish an adequate bite.
- When there is an occlusion problem between the upper and lower jaw and the correction cannot be carried out with other means such as orthopedics, surgery, maxillary expansion, etc., tooth extraction can help to achieve this.
- If there is a lack of space for a correct bite alignment.
- Teeth with cavities and a high degree of destruction.
- Teeth broken by some type of trauma or accident and that cannot be rebuilt.
- Teeth whose degree of insertion in the bone does not allow their displacement.
Usually the first premolars are the most frequently extracted teeth, both to reduce dental crowding and to retrude the incisors in case of protrusion. Normally they are the ones that are extracted most frequently because the space they occupy is used conveniently, since these teeth are located close to the incisors, which is where the crowding is usually greater or it is the teeth that have to be retracted.
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