Orthotown JanuaryFebruary 2025 - 19
have plenty of space to retract the upper anterior teeth by extracting upper 5s and 6s. Again, Tip Edge braces would
work great.
It is a little aggressive but doable, I think. Again, I'd love to see models, and I'd be prepared for palatal TADs in
some fashion, either to conserve anchorage or to blow anchorage, especially on the right side someday.
Talk to the surgeon about the cysts and the lower 8s. n
srensch
Post: 6 of 7
2/11/2019
Not sure why you want to remove an upper premolar and a molar in a near class I dental (class II skeletal) case.
Please explain, ZXZXZX.
I think extracting either upper and lower 1st molars OR 4s/6s would work just fine. I lean toward 4s/6s due to
wanting to get going on treatment sooner and not wanting to wait on the eruption of 7s. n
zxzxzx
Post: 7 of 7
2/13/2019
I think extracting either upper and lower 1st molars OR 4s/6s would work just fine. I lean toward 4s/6s due to wanting
to get going on treatment sooner and not wanting to wait on the eruption of 7s.
I assume the lower anterior teeth will upright to some extent after the
6s are removed. This will increase the OJ. If it were my case, I'd encourage
that uprighting with class III elastics.
The UL6 is class II, and the upper left 5 is palatally impacted and completely
out of the arch. So, it is as if it has already been extracted. Taking
the UL4 or UL5 will result in very little space being available for OJ correction,
so hence I feel that the UL5-6 should be extracted.
Not sure if you extract many upper 7s in your practice, but that is one
of my favorite things to do. Once you have some experience with that and
also read the literature on how often upper 8s will come in as usable teeth
in teens, the fear of removing first molars dissipates.
The real issue is how to handle the opposite side. Really not sure if you
should just extract 4 or 5-6 and then use TADs to protract the UR7. Here
is where models would help.
You made a comment about wanting to move along and get the case
done as quickly as possible, and that is, of course, a good thing in general.
I think though, in a less-than-usual case, time can be your friend.
I hope that helps and that I answered your question. n
Join the conversation!
Share your insights and experiences
with challenging Class II cases. What's
your go-to approach for balancing
aesthetics and function? Let your
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