Orthotown December 2019 - 24
message board
This Extraction May Worsen
the Face of This Girl
A 12-year-old patient's mother is worried about her chin and this doc
is hesitant to start with extractions. Is there a better way?
HJS
Member Since: 01/07/06
Post: 1 of 31
The patient is a 12-year-old girl with a chief complaint about crooked teeth. She is Class I
(ANB 4), WITS 2mm, Class I molar and canine. There is mild crowding in the maxilla and
moderate crowding in the mandible with deep curve of Spee. The lower midline is shifted to the
right with 5mm overjet.
My treatment plan is to extract 4s, but the mother is worried about chin appearance. What
do you suggest for this case? ■
8/30/2019
danbraces
Member Since: 11/09/08
Post: 2 of 31
justinudm
Member Since: 09/29/14
Post: 6 of 31
Needs a ton of transverse dimension. Get some mounted casts and I think you'll find this out. ■
9/3/2019
From what I can see, this looks like a hyrax followed by extraction of U/L5s due to the L5s
being excessively large and the amount of lower crowding. The upper incisors are severely flared,
which contributes to the upper crowding as well. The issue here is the skeletal deep bite, so from
Day One after expansion, I would be on U/L7-7 to help level/align and open the bite. If you
don't take teeth out, you are going to excessively flare both arches.
I'm interested to see what others say. ■
9/4/2019
How would you treat this patient?
Doctors share their opinions all the time on Orthotown's message boards, including on difficult
cases like this Townie posted. If you would like to weigh in, go to orthotown.com/magazine and
find a link to this message board in the December lineup.
24
DECEMBER 2019 // orthotown.com
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