Orthotown March 2021 - 15
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Blocked-Out Premolars
This case illustrates the challenge of whether to create space and align or extract and close space
Situations with blocked-out premolars can present an interesting conundrum, in terms of
whether to create space and align or to extract and close space.
A multitude of factors influence the decision, including existing incisor inclinations, molar
relationship, potential for growth, overjet, crowding, etc.
Here's an example of a 13y 4m male who presented with such a situation. The extraction plan
could potentially have been shorter and more simple; however, factoring in mand. growth, this
would also necessitate more protraction of the maxillary molars (if the goal were to maintain or
advance maxillary incisor position).
Thus, the decision was made to align the premolars instead. The patient exhibited significant
growth during treatment.
The upper incisors proclined 8-10 degrees, so the slots were inverted toward the end to get
some uprighting. There was a slight change in inclination, but the upper incisors, while not
unaesthetic, are still about 4-5 degrees too proclined. â
FenrisĂșlfr
Member Since: 02/25/09
Post: 1 of 7
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