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Braces

Extracting Bicuspids

08/18/2009

Question:

My ortho wants to extract my daughters first bicuspids on upper and lower to make room. ( # 5, 12, 21 & 28) My question is ... Is it common to do that? She has Class II Div Malcclusion with overjet 10mm. overbite 90% max crowding 6mm and Mand crowding 5 mm root canals on 8 & 9 due to injury just do not want anymore teeth gone if not needed.Plus presence of wisdoe teeth We already did the expander before 8 & 9 got injured. Right now she has headgear and I thought that was to make room can you please help?????

Answer:

First of all, the headgear is designed to hold back the upper arch of teeth to allow the mandible (lower jaw ) to grow forward. The amount of overjet (horizontal) and overbite make it sound like a severe case. Therefore the extraction of teeth does not seem incorrect. 

I think the critical decision is: What is the life expectancy of the upper front teeth? 

If they are in jeopardy, then perhaps these should be removed and the lateral incisors moved together and the canines be brought forward to simulate lateral incisors. This may seem radical so the decision hinges on the root length of the central incisors. 

If they are good I would favor bicuspid extractions; if not, then my idea would deserve discussion. 

Please review the options with your orthodontist. Good question! 

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Response by:

Walter C Buchsieb, DDS, MS Walter C Buchsieb, DDS, MS
Professor Emeritus - Clinical, Associate of Dentistry
College of Dentistry
The Ohio State University