Orthotown September 2013 - (Page 12)

orthotown.com // message board This Townie can’t see why an orthodontist would want to extract maxillary second molars. Others say it’s the best-kept secret. » Orthotown.com > Message Boards > Clinical Topics > Clinical Orthodontics > Extracting Second Molars: Best-Kept Secret in Orthodontics abc123 Member Since: 01/10/13 Post: 1 of 16 t There are many more discussions about second molars on Orthotown.com. Search for the message boards below and add your input. Impacted Mandibular Second Molar(s) Search: Second Molars Second Molars and Treatment Initiation Search: Treatment Initiation t Extracting Second Molars? My 10 year-old niece (just started braces) was visiting with me this past week and her mother tells me that her orthodontist wants her to get her maxillary second molars extracted. Her general dentist thought this was odd and mentioned she would talk to the orthodontist about it. I look in her mouth and note that she is Class I molar and premolars, with slightly end-to-end canine relationships with 3mm OJ and 40 percent OB. She has mild crowding (i.e., 2-3mm) and some proclination to her maxillary incisors (though not excessive). To me, it looks like a non-questionable non-extraction, rubber bands case. I don’t have any records to review, but I do have the report the orthodontist gave the parent and general dentist, which states that she has: • edge-to-edge molar relationships (which I did not see) • upper/lower crowding • upper cuspids labially malposed • deep overbite • upper anterior protusion I just can’t see why the orthodontist would want to extract maxillary second molars, do you? Even if the patient were considered Class II or to have crowding or excess proclination, I still don’t know what indication there’d be for extraction of maxillary second molars. When the general dentist asked the orthodontist about it he just said, removing the second molars would allow for the eruption of the third molars, so it should be okay. Thought I’d put it out there to see if anyone is more familiar with what the treatment philosophy they are implementing might be. n JUN 22 2013 zxzxzx Member Since: 02/28/03 Posts: 2 & 3 of 16 12 I do that a lot. In this case, if the molars are end on or if there is a vertical component to the malocclusion, extracting upper 7s can make things much easier to treat and the final result more stable. Again, talking about your case, “rubber bands” means you are willing to procline the lower anterior teeth to resolve the Class II problem. We all do that. I’d rather do an HG but who will wear that? But doing an HG means you are altering growth to get your Class II correction and using Class II elastics, many orthos feel, is a compromise relative to HG as far as stability is concerned. Who knows? When I was at UNC for the mini residency, a third year presented a recent deband case in which a 13-year-old was supposed to wear a HG for Class II correction. Surprise, surprise, she didn’t. So at the end, the student and faculty member gave her Class II elastics to finish the case. If Class IIs were a good idea, why didn’t they start that way? I asked Proffit if they ever removed upper 7s in a case like that. He was not happy with my question. When I was new at this, I had the opportunity to spend that day at BU with Gianelly courtesy of GAC. I only wanted to ask Gianelly one question: When you distalize a 6 with HG, Wilson mechanics, etc., does it stay back? The answer was, of course not. It basically SEPTEMBER 2013 // orthotown.com http://www.orthotown.com http://www.Orthotown.com http://www.dentaltown.com/MessageBoard/thread.aspx?a=11&s=6&f=693&t=126103&g=1 http://www.orthotown.com/MessageBoard/thread.aspx?a=11&s=6&f=693&t=114218&g=1 http://www.orthotown.com

Table of Contents for the Digital Edition of Orthotown September 2013

Orthotown.com Highlights
Wired for Success: Patient Appreciation Events: The Best Marketing ROI, Hands Down!
Tribute: Dr. Vincent Kokich Tribute
Extracting Second Molars?
New Office Design
Tough Case
GORP – What’s Happening Among New Grads?
Corporate Profile: Ortho2
Get in Front with Facebook’s Graph Search
The Role of CBCT in Management of Severe Bilateral Condylar Fractures in the Growing Patient
Perspective on 3D Imaging, ALARA, i-CAT and CBCT Justification
You Should Know: Cultura Management
Office Visit :Teeth, Tech, Time and Tickets
Ad Index

Orthotown September 2013