Mandibular incisor extraction--postretention evaluation of stability and relapse

The influence of 3x3 bonded retainer on anterior crowding relapse in mandibular incisor extraction cases

Objective:

To evaluate the 3x3 bonded retainer influence on the mandibular anterior crowding in cases treated with mandibular incisor extraction

Methods:

The sample comprised pretreatment, posttreatment and follow-up orthodontic records of 16 subjects (10 females and 6 males) with Class I malocclusion treated with extraction of a single mandibular incisor. The mean ages (± SD) at pretreatment, posttreatment and follow-up evaluation were 23.45 ± 9.14 years, 25.50 ± 8.95 years and 30.11 ± 8.59 years, respectively. The mean (± SD) treatment time and posttreatment evaluation time were 2.05 ± 0.45 years and 4.60 ± 1.85 years , respectively. Little irregularity index and interdental widths were evaluated using dental casts. The sample was divided into two subgroups, according to the presence of the 3x3 bonded retainer at follow-up.

Results:

The subgroup without 3x3 bonded retainer presented a greater relapse at the follow-up, when compared to 3x3 bonded retainer subgroup.

Conclusion:

There was a significant relapse in cases treated with mandibular incisor extraction at follow-up. The subgroup without 3x3 bonded retainer showed a significant relapse at the follow-up when compared to the retainer group.

Evaluation of objective and subjective treatment outcomes in orthodontic cases treated with extraction of a mandibular incisor

OBJECTIVES

To analyze changes in occlusal characteristics following mandibular incisor extractions (MIE), to determine the usefulness of wax setups in treatment planning MIE cases and to compare the pre- and posttreatment dental attractiveness between MIE cases and nonextraction (NE) controls.

MATERIALS AND METHODS

The Peer Assessment Rating (PAR) Index was used to score pre- and posttreatment dental casts of MIE cases (n = 14) and matched NE controls (n = 14). Occlusal characteristics were evaluated on diagnostic wax setups and posttreatment casts. Attractiveness of pre- and posttreatment cases judged on intraoral photographs of cases (n = 6) and controls (n = 6) were rated by 76 dental students and 10 laypeople using visual analogue scales (VAS).

RESULTS

The difference in PAR score reduction (%) between the MIE and NE groups was not significant. Between the wax setup and posttreatment casts, there were moderate correlations in overjet, overbite, and right canine classification. There was no significant difference in pre- and posttreatment change in VAS scores (%) for attractiveness between the MIE (49.8 ± 4.3 [S.E.]) and control groups (40.8 ± 4.3 [S.E.]). However, there was a significant difference (P = .000) between the observer groups.

CONCLUSIONS

There were no significant differences in the treatment outcomes of orthodontic cases treated with MIE or NE, indicating that MIE is a valid treatment option. A wax setup is moderately correlated with posttreatment results. Both laypeople and dental students rated posttreatment dental attractiveness higher than pretreatment in MIE and NE groups. Dental students tended to be more critical than laypeople in their ratings.

A 15-year follow up of an orthodontic treatment including a lower incisor extraction and keeping the maxillary canine-premolar transposition

Lower incisor extraction is an effective option for treating lower anterior crowding in patients with a good facial profile, Class I molar occlusion, and narrow upper incisors. This report describes the successful treatment of an adolescent patient with lower anterior crowding and a transposed maxillary canine and premolar treated by extracting a lower incisor and keeping the transposed positions of the teeth. With the use of retainers, treatment results were stable up to the 2-year postretention visit. However, upon a 15-year postretention appointment, the fixed retainer had been removed and the removable retainer was no longer in use, which resulted in relapse of lower anterior alignment. Moreover, the transposed canine had extruded during this period, causing occlusal interference and gingival recession, as well as loss of tooth vitality, which indicates the importance of maintaining orthodontic retainers for long-term stable occlusion.

Virtual orthodontic setup in orthodontic camouflage planning for skeletal Class III malocclusion

The purpose of this paper was to emphasize the importance of the orthodontic setup in treatment planning for skeletal Class III malocclusion correction in an adult patient with moderate lower anterior crowding and anterior crossbite associated with two supernumerary lower incisors.

Orthodontic management of a dilacerated central incisor and partially impacted canine with unilateral extraction - A case report

Aim

To align a dilacerated maxillary central incisor and partially impacted canine with unilateral extraction in a young patient with skeletal deep bite.

Materials and methods

A 14 year old male patient reported to the hospital with skeletal deep bite (basal plane angle-17°), severe horizontal pattern of growth (Go-Gn to Sn -22°), upright maxillary incisors (U1 to NA -26°) and retroclined lower incisors (L1 to NB -11°). The maxillary left central incisor was dilacerated, and the maxillary left canine was partially impacted. Unilateral extraction of the left maxillary premolar and left mandibular central incisor was done. A canine disimpaction spring was used to align the impacted canine. An anterior bite plane was given to open the bite.

Results

Superimposition of lateral cephalogram (T1, T2) revealed bite opening, normal overjet and overbite. There was backward rotation of the mandible and increase in lower anterior facial height. There was no evidence of root resorption or loss of vitality in the dilacerated tooth. Clinically the canine was well aligned in the arch.

Conclusion

Orthodontic management of a dilacerated incisor can be done without root resorption or loss of vitality. The partially impacted canine was well aligned in the arch. Unilateral extraction can produce good treatment results.

Mandibular incisor extraction: a 5-year follow-up

This case report presents the mandibular incisor extraction treatment of a patient with dental Class I malocclusion and lower crowding, in whom one mandibular incisor extraction was selected as the treatment of choice to improve the dental occlusion. A 19-year-old male patient’s chief complaint was the crowding of lower incisors. He had a straight profile with normal upper and lower lip projection. Upper and lower dental midlines were coincident with the facial midline. The patient had Class I molar and canine relationships on both sides. He had Class I skeletal relationship, low angle vertical pattern, and proclined upper and lower incisors. The treatment plan included the extraction of lower right central incisor to resolve the crowding. At the end of 16-month active fixed treatment, lower dental crowding was resolved. At the 5-year follow-up, the patient had a stable occlusion, with the results of the orthodontic treatment maintained.

Unusual Case of Extraction of Maxillary Lateral Incisors and Mandibular Central Incisors

INTRODUCTION

This article's purpose is to report a case where maxillary lateral incisors and mandibular central incisors are extracted and a canine substitution was performed as the best therapeutic option in order to obtain symmetry in a malocclusion with an upper lateral incisor with poor prognostic, solve moderate crowding, get enough space for the permanent dentition, and provide stability to the results.

CASE REPORT

An 11-year-old boy with straight profile with acute-to-normal nasolabial angle and protruded lips, mixed dentition, lower and upper severe crowding, and a bilateral molar angle Class I. The left maxillary lateral incisor failed endodontic treatment secondary to an intrusive traumatic lesion in the primary and permanent dentition. The treatment of choice was the extraction of both upper lateral incisors and both central lower incisors. The patient finished with molar and canine angle Class I and coincident midlines and was functionally stable; both lateral and protrusive jaw movements were effectively made by the first premolars and central incisors and canines without improper contacts of the rest of the teeth. Overbite of one-third and correct overjet were also achieved, and the esthetic outcome was satisfactory due to the composed material restorations of both the central and lateral incisors, as well as recontouring of the first maxillary premolars.

Mandibular incisor extraction treatment in Angle's Class I malocclusion with peg-shaped maxillary lateral incisors

Accurate diagnosis and treatment planning are essential for obtaining ideal treatment result in cases involving mandibular incisor extraction. This case report describes a 15-year-old female with balanced soft-tissue profile, peg-shaped maxillary lateral incisors, and moderate mandibular anterior crowding treated with a mandibular incisor extraction. Ideal overbite and overjet were achieved. “Black triangle” formation was avoided due to the bodily movement of mandibular incisors and the use of uprighting springs for ideal axial inclination of mandibular incisors. A mandibular incisor extraction can be an effective treatment option in carefully selected clinical situations.

Frequency evaluation of different extraction protocols in orthodontic treatment during 35 years

BACKGROUND

Studies that show frequencies of different orthodontic treatment protocols can be used as valuable parameters in the interpretation of treatment tendency with time. The purpose of this retrospective study was to evaluate all orthodontic treatment planning conducted at the Orthodontic Department at Bauru Dental School, University of São Paulo, Brazil, since 1973, in order to investigate extraction and non-extraction protocol frequencies selected at each considered period.

METHODS

The sample comprised 3,413 records of treated patients and was evaluated according to the protocol choice, divided into 10 groups: Protocol 0 (non-extraction); Protocol 1 (four first premolar extractions); Protocol 2 (two first maxillary and two second mandibular premolars); Protocol 3 (two maxillary premolar extractions); Protocol 4 (four second premolars); Protocol 5 (asymmetric premolar extractions); Protocol 6 (incisor or canine extractions); Protocol 7 (first or second molar extractions); Protocol 8 (atypical extractions) and Protocol 9 (agenesis and previously missing permanent teeth). These protocols were evaluated in seven 5-year intervals: Interval 1 (1973 to 1977); Interval 2 (1978 to 1982); Interval 3 (1983 to 1987); Interval 4 (1988 to 1992); Interval 5 (1993 to 1997); Interval 6 (1998 to 2002); Interval 7 (2003 to 2007). The frequency of each protocol was compared between the seven intervals, using the proportion test (P < 0.05).

RESULTS

The results showed that 10 protocol frequencies were significantly different among the 7 time intervals.

CONCLUSIONS

The non-extraction protocol frequency increased gradually with consequent reduction of extraction treatments. The four premolar extraction protocol frequency decreased gradually while the two maxillary premolar extraction protocol has maintained the same frequency of indications throughout time.

The role of extraction in stability of orthodontic treatment

Long-term postretention assessment of orthodontically treated cases has been of interest for 5 decades; however, extraction versus nonextraction follow-up studies are difficult to compare without regard to sample structure, therapy concept und different parameters. The results of selected studies- extraction of 1 or 2 incisors, of premolars and of second and third molars, early and late extraction therapy and serial extraction-showed that long-term postretention stability is not a realistic treatment goal. The Cologne long-term records allow optimistic prediction: relative stability has been found in the majority of former patients, irrespective of the kind of treatment and treatment time. Original anomaly, type (extraction/nonextraction) and amount of treatment, and end-of-treatment alignment were found to be major factors influencing dentoalveolar and skeletal post-treatment changes. The conclusion is that therapy-induced post-treatment changes can be reduced by having a treatment goal within the anatomic limits.