Extracciones

Orü,cKi™,¡c S.c,«y.

Serial extraction as a corrective procedure in dental orthopaedic therapy
Birger Kjellgren
Eastnnan Institut, Stockholm, Sweden {Transactions of the European Orthodontic Society 1947/48, pp. 134-160)

SUMMARY According to experience, malocclusions characterized by crowding of fhe teeth and contraction of the jaws usually cannot be treated with lasting results withoutreduction of the number of teeth. In some of these cases acceptable results can be obtained just by extractions, even without the use of appliances. In order to direct the development of the occlusion in contraction cases along the most favourable lines, it is suitable to plan for the advisable or necessarv extractions at an early age. The extractions will concern at first certain deciduous andlater some permanent teeth. This line of extraction treatment is called serial extraction by the author, who has practiced the method for about 20 years. A serial extraction is usually performed in the following way. If in a contraction case the incisors, particularly the laterals, are erupting in crowded and distorted positions, extractions are made of the deciduous canines. This treatment will,in well diagnosed cases, resuít in a very clear improvement of the incisor positions. Some year later extraction of fhe first deciduous molar might be done to facilitate and speed the eruption of the first premolar. At the time of the eruption of the permanent canines an extraction of some permanent tooth, usually the first premolar, is made, which will facilitate the normal eruption of thecanines. The serial extraction method is practised in both jaws in cases of bimaxillary contraction, Class I. In Class II cases with contraction and protrusion of the upper jaw, it is employed in the maxillary arch. In cases of Class III characterized by crowding of the lower incisors, serial extraction is used with good results in the mandibular arch. The serial extraction method is more suitable incases of normal overbite or even open bite than in cases of deep overbite. According to experience, it does not cause impaction or retardation of eruption of the canines. Serial extraction is a suitable preliminary treatment technique in those cases in which subsequent appliance treatment is planned, since it will often greatly facilitate this later treatment. The author illustrates the serialextraction method by a casuistic including treated cases.

Introduction . , , , The aim in denta orthopaedtc treatment is. as Angle has ^ „ . „ . , • potnted out, to therapeuttcally so tnfJuence a developtng or '^ , . . , 1 • fit ly developed maloceluston tbat a normal oceluston is . . . -X-, • UI J f _ reached and maintamed. The experience assembled irom , J ^ ,„ , ^u„A^ a large number of dentalorthopaedic n-eatment methods " . ,,. , .• L ,1. e J .j ,..u\^ in the past halfcentury. including both fixed and removable ,. " ^ , .. , ,• , • , f,^ .,-^1 „,^,h apphanees. labial or lingual, intra- or extra-oral, with . '^ . . K , „I „r „....„11, intemiittent or continuous force, functional or purely . „ ir L u ,^- o ,.„thor i;n.itp/) mechanically effective, shows, however, a rather limiteö . .. . „„„¡..IK, m^infuininn tliie possibility of reaching, and especially maintaining, tins : , , , _ , . I ^ ^ , 1 , „f „i.,nco üftpr ihf ideal result. There is more or less nsk ot relapse aner tue ^ , r ^ • ™.,i„^„i„ci/i>, n;r,í.= Prpçpni final treatment of certain malocclusion types, present experience especially shows a strong tendency of recurrence in cases of evident crowding and contraction.It is frequently necessary in these eases to be satisfied with a compromise treatment The size of the jaws may make it necessary to reduce the denta! units where the bones are too small to allow a perfect occlusion in order to obtain a fiinetioning and aesthetic optimal result. Although extractions are fundamentally unsympathetic, they are, however, necessary for treatment ofmanymalocclusions,...