The extraction of a lower incisor in The extraction of a lower incisor in orthodontic treatmentsorthodontic treatments

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indicationsindications

Angle class one Molar relationship with arch Angle class one Molar relationship with arch lenth-tooth size discrepancy from 4 to 7 mm, lenth-tooth size discrepancy from 4 to 7 mm, normal upper arch that does not need normal upper arch that does not need premolar extractions.premolar extractions.

Bolton discrepancy with mandibular excess Bolton discrepancy with mandibular excess of 4 to 6 mm. of 4 to 6 mm.

When lower expansion is impossible or When lower expansion is impossible or compromising for periodontal health (risk of compromising for periodontal health (risk of gingival recession)gingival recession)

indicationsindications

Angle class one biprotrusion with lower front crowding.

Class two by maxillary squeletal protrusion with lower incisors crowding.

Mild squeletal class three. Orthodontic retreatment for relapsing

lower anterior crowding…

Advantages Advantages

Extracting one incisor rather then 4 Extracting one incisor rather then 4 premolars, less teeth are sacrificedpremolars, less teeth are sacrificed

Shorter treatment time with fixed appliances. Shorter treatment time with fixed appliances. The tooth movement needed is therefore The tooth movement needed is therefore minimal.minimal.

Lower incisor extraction is a compromise Lower incisor extraction is a compromise solution for adults who need a relatively fast solution for adults who need a relatively fast outcome.outcome.

No negative consequences on soft tissue No negative consequences on soft tissue profile.profile.

DisadvantagesDisadvantages

Acceptable aesthetic result but the Acceptable aesthetic result but the occlusion is not always a perfect class occlusion is not always a perfect class one.one.

Lower midline deviation.Lower midline deviation.

Formation of a black triangle due to Formation of a black triangle due to papillear defect between lower incisors.papillear defect between lower incisors.

counterindications

Angle class II division 2 with deep overbite.

Tooth size- arch length discrepancy where premolar extractions are more convenient.

Important class II or class III squeletal discrepancy.

Complimentary examsComplimentary exams

Study castsStudy casts X- RaysX- Rays Set UpSet Up

Chosing the tooth to be extracted. The most malpositioned tooth or the

one with gingival defect ( gum recession)

Pathological Extraction of the 32 and fracture and important apical

lesion on 32 and 33.

Kenza LAHLOU, Aalloula EL HOUSSAINE

Clinical case 1:class III tendency.Clinical case 1:class III tendency.

ROSS J. MILLER, TRANG T. DUONG,MITRA DERAKHSHAN

Clinical case 2 : Biprotrusion

Clinical case 3:

José Roberto Oliveira José Roberto Oliveira FLORIACHFLORIACHEwaldo Luiz de ANDRADE Ewaldo Luiz de ANDRADE 

Clinical case 4 : lower incisor with pathology

Zachrisson, Keim

Clinical case

Zachrisson, Keim

Closure of extraction spaceClosure of extraction space

Reinaldo Mazzottini

Biprotrusion

Kenza LAHLOU, Aalloula EL HOUSSAINE

Thousand years old Thousand years old Oak tree.Oak tree.

Bibliography Bibliography

BIONDI Giovanni , via Don Pastega 8, 31052 Varago di Maserada (TV), BIONDI Giovanni , via Don Pastega 8, 31052 Varago di Maserada (TV), Italie.Italie.InternationalInternational

Orthodontics Vol 4, N° 1 - mars 2006pp. 63-72 Doi : ORT-03-2006-4-1-1761-7227Orthodontics Vol 4, N° 1 - mars 2006pp. 63-72 Doi : ORT-03-2006-4-1-1761-7227 101019-20060162101019-20060162

ROSS J. MILLER, TRANG T. DUONG,MITRA DERAKHSHAN VOLUME XXXVI NUMBER 2 © 2002 JCO, Inc.

Zachrisson Keim, VOLUME XXXIX NUMBER 4 © 2005 JCO, Inc.

FLORIACHE José Roberto Oliveira waldo Luiz de ANDRADE, Heterodox extractions analysis on the malocclusions treatment

PINTO, M. R.; MOTTIN, L. P.; DERECH, C. D.; ARAÚJO, M. T. S ,R Dental Press Ortodon Ortop Facial 118 Maringá, v. 11, n. 1, p. 114-121, jan. /f ev. 2006

Mazzottini Reinaldo R Clin Ortodon Dental Press, Maringá, v. 4, n. 5 - out./nov. 2005

LAHLOU Kenza , Aalloula EL HOUSSAINE Rev Odont Stomat 2008;37:59-72