Serial Extractions Flashcards
Early orthodontic intervention
Indications:
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- Posterior & anterior crossbites.
- Ankylosed teeth.
- Excessive protrusions and diastemas.
- Severe anterior and lateral open bites.
- Ectopic molars.
- Pseudo Class III patients.
- Cleft palate patients.
- Severe arch length discrepancies.
Evaluated the available space by changes in
(2)
Serial dental casts of 182 North American white
individuals between 3 and 16-18 years of age
intercanine width and arch length
Changes in Arch Dimension
Maxilla AL
Primary
Mixed
Permanent
28.5
29.9
28.8
Changes in Arch Dimension
Maxilla IC
Primary
Mixed
Permanent
28.8
32.0
33.6
Maxillary arch …
Maxillary intercanine distance …
length remains the same
increases 4.8mm
Changes in Arch Dimension
Mandible AL
Primary
Mixed
Permanent
25.5
25.3
23.5
Changes in Arch Dimension
Mandible IC
Primary
Mixed
Permanent
22.3
25.5
25.5
Mandibular arch length …
Mandibular intercanine distance …
decreases 1.7mm.
increases 3.2mm
Leveling the curve of Spee: its effects on
mandibular arch length
To estimate the needed arch length to level the
curve of Spee, measure the
maximum depth of
the curve on both sides, get the average
measurement and add 0.5mm
Interpretation of the Mixed Dentition Analysis.
If the mixed dentition analysis predicts that
there is not a crowding problem,
continue with
periodic patient observation.
If the mixed dentition analysis predicts light
crowding (1 - 4 mm.),
maintain the arch length
with any appliance and examine the patient
periodically, probably there will be a need for
future orthodontic treatment
If the mixed dentition analysis predicts crowding
of more than 4mm.,
most probably the patient
will develop crowding in the permanent dentition
which will require orthodontic treatment after a
thorough evaluation
If the mixed dentition analysis predicts crowding
in excess of 6mm. In the mandibular arch, the
patient will benefit form
serial extraction therapy
Serial extraction is the orderly removal of
deciduous and permanent teeth in a determined
sequence.
(6)
- Skeletal class I.
- Dental class I.
- Bimax dental protrusion.
- Dental crowding in excess of 6mm.
- Light or anterior open bite tendency.
- No congenitally missing second bicuspids
Main benefits of serial extraction.
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- Naturally induced movement and
alignment of severely crowded anterior
teeth. - Health improvement of the adjacent
tissues. - Psychological and cooperation
improvement, due to the incisor
alignment. - Decrease on the orthodontist work load
and stress. - Less iatrogenic damage.