what are the indications for serial extraction
- posterior and anterior crossbites
- ankylosed teeth
- excessive protrusions and diastemas
- severe anterior and lateral open bites
- ectopic molars
- pseudo class III patients
- cleft palate patients
- severe arch length discrepancies
what is another name for serial extraction
early orthodontic intervention
what are the changes in arch dimension in the maxilla
- maxillary arch length remains the same
- maxillary intercanine distance increases 4.8mm
what are the changes in arch dimension in the mandible
- mandibular arch length decreases 1.7mm
- mandibular intercanine distance increases 3.2mm
how do you estimate the needed arch length to level the curve of spee
measure the maximum depth of the curve on both sides, get the average measurement and add 0.5mm
if the mixed dentition analysis predicts that there is not a crowding problem what do you do?
continue with periodic patient observation
if the mixed dentition analysis predicts light crowding (1-4mm) what should you do
maintain arch length with any appliance and examine the patient periodically, probably there will be a need for future ortho treatment
if the mixed dentition analysis predicts crowding of more than 4mm what should you do
the patient will develop crowding in the permanent dentition which will require orthodontic treatment after a thorough evaluation
if the mixed dentition analysis predicts crowding in excess of 6mm what should you do
in the mandibular arch the patient will benefit from serial extraction therapy
what is serial extraction
the orderly removal of deciduous and permanent teeth in a determined sequence
what are the prerequisites for serial extraction
- skeletal class I
- dental class I
- bimax dental protrusion
- dental crowding in excess of 6mm
- light or anterior open bite tendency
- no congenitally missing second bicuspids
what are the benefits of serial extraction
- naturally induced movement and alignment of severely crowded anterior teeth
- health improvement of the adjacent tissues
- psychological and cooperation improvement due to the incisor alignment
- decrease the orthodontist work load and stress
- less iatrogenic damage
what are the main disadvantages of serial extraction
- increase of the overbite
- lingual inclination of incisors
- scaring tissue on the extraction spaces
- diastemas
what does conventional serial extraction do
- premature extraction of deciduous canines provides the space for the incisors to assume normal position over supporting bone
- extraction of the first deciduous molars permits the desirable early eruption of the first premolars
- final extraction of first premolars makes it possible for the canines to erupt in a favorable direction
what are the prerequisites for alternative serial extraction
- borderline malocclusion
- deciduous cuspids are present
- moderate loss of arch length
- no irregularity on lower incisors
- no gingival recession
- second deciduous molars in place for a long time
what are the two types of serial extraction
conventional serial extraction
alternative serial extraction
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