What criteria determine whether to extract or not?

Hello.

I'm Dr. Son Su-min, an orthodontic specialist who has been practicing at Guardians Dental Myeongdong for 20 years.

Do I have to extract teeth to get orthodontic treatment? Is non-extraction orthodontic treatment possible?

This is one of the most frequently asked questions when consulting for orthodontic treatment at Guardians Dental Myeongdong.

Since extracting teeth that appear to have no problems can be burdensome, many people want to receive non-extraction treatment if possible.

In orthodontic treatment, extraction and non-extraction are not issues where one can be determined as better than the other.

We need to analyze the degree of tooth overlap, the angle of the front teeth, the lip line, facial balance, the occlusion of the upper and lower teeth, and the range of the gums and bones surrounding the teeth to determine the best approach for each individual.

Therefore, non-extraction orthodontic treatment may be suitable for some people, while extraction orthodontic treatment may be a more appropriate choice for cases where sufficient space needs to be secured and the position of the front teeth needs to be adjusted.

So, what do we look at to determine extraction and non-extraction in actual practice?

Today, we will explain the criteria for determining extraction and non-extraction, along with actual treatment cases.

Photos of the patient at the time of visit

The patient visited us with concerns about crooked teeth.

Looking at the intraoral photos, we can see that the overall tooth arrangement is uneven and many teeth are out of position.

Let's take a closer look at what needs to be improved.

Why orthodontic treatment was needed

Severe tooth crowding

The teeth were overlapping and rotating, resulting in an uneven tooth arrangement.

Looking at the upper teeth from above, the crowding and space deficiency of the front teeth were prominent.

The front teeth were protruding

From the side, we can see that the upper front teeth were protruding.

We analyzed the inclination and position of the front teeth, as well as the skeletal relationship between the upper and lower jaws, using a lateral cephalometric X-ray.

Non-Extraction Orthodontics VS Extraction Orthodontics

Guardians Dental Myeongdong, Treatment Process

We use X-rays and orthodontic analysis programs (v-ceph) to compare the expected changes in extraction and non-extraction treatments.

After explaining the analysis results and the pros and cons of each method, we discuss with the patient to determine the appropriate treatment direction.

However, simulations are expected data to help with treatment planning, and actual results may vary from person to person.

1. Securing insufficient space: We extracted the small molar (behind the canine) to secure space for the overlapping teeth to move.

Then, we arranged the teeth that were out of line and moved the front teeth that were leaning forward backward.

1. Arranging and adjusting the front teeth angle: After securing the space, we slowly moved the teeth that were out of line back to their original position.

In this process, it's crucial to not only arrange the teeth neatly but also continuously check that the front teeth are not overly leaning forward.

1. Adjusting the upper and lower bite: After the teeth were somewhat arranged, we adjusted the detailed bite to ensure the upper and lower teeth fit together stably.

After Treatment

After treatment, we can see that the front teeth are now neatly arranged.

Before treatment, the upper and lower front teeth were crooked and rotated, but after treatment, they are more evenly arranged.

We used the space secured by extraction to move the front teeth that were leaning forward backward.

As a result, we can see that the protrusion and angle of the front teeth are alleviated when viewed from the side.

In Conclusion

Extraction or non-extraction, which is a better treatment?

In orthodontic treatment, there is no one-size-fits-all answer to extraction and non-extraction.

Rather than deciding based on simple criteria such as "I don't want to extract teeth" or "extraction will make me look better",

it's essential to analyze the arrangement of teeth, the angle of the front teeth, facial balance, occlusion, and the space available to move teeth.

This is because extraction orthodontics and non-extraction orthodontics have different advantages and disadvantages, as well as varying applicability.

The key point is not that one method is always better, but rather to determine which treatment direction is more suitable for each individual.

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We hope that patients considering orthodontic treatment will keep this in mind and consult with an orthodontic specialist who has sufficient clinical experience to guide them towards the most suitable method.

• From Dr. Son Su-min - ▼ Guardians Dental Myeongdong preview ▼

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NAutomatically translated from the Korean post on our Naver blog. Read the original ↗