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KMID : 0362720190570060326
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Journal of the Korean Dental Association
2019 Volume.57 No. 6 p.326 ~ p.332
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Severe crowding : Is nonextraction treatment possible?
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Jung Min-Ho
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Abstract
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Extraction treatment has been used for a long time to treat crowding or lip protrusion patients and still extraction decision is the most difficult and important decision during diagnosis and treatment planning. If the amount of crowidng is severe, premolar extraction is often considered. Because of their location, premolar extractions would seem to allow for the most straightforward relief of crowding and the improvement of soft tissue profile. But patients and their parents often prefer nonextraction approach if possible and such a preference gives us serious question about the boundary of nonextraction treatment.
Because Orthodontic Mini-Implant (OMI) become popular these days, distalization of posterior teeth can be obtained easily without patient's compliance. For this reason, many orthodontists are trying to treat crowding patient with nonextraction than before. But sometime, unexpected side effects are observed including unesthetic profile, impaction of second molar and long treatment time.
All the tools for space gaining ? extraction, arch expansion, molar distalization and interproximal enamel reduction - have their limitations and indications. Possible side effects and limitations should be carefully considered during the treatment planning.
Although Korean patients usually require extraction more often than US or European patients, more knowledge about the tools for space gaining would help us to decrease the rate of extraction and the problems during treatment of crowding patients.
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KEYWORD
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extraction, Orthodontic mini-implant, distalization, interproximal stripping, expansion
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