Weekly Question and Answer session. May 01, 2019

We had an excellent question and answer session this morning – and one that demonstrated numerous aspects to assessing and treatment of an orthodontic case. 

This patient first presented as a nine year old male – with severe crowding in his upper anterior segment and a full class II buccal relationship. Discussion revolved around what type of early intervention would have been appropriate in this case, and possibly utilising a modified serial extraction approach with purely the removal of the upper deciduous canine's, upper deciduous first molars and upper first premolars. Unfortunately the  father refused to have any extractions at that time.

He then presented again as a 13 year old boy with severe crowding, with lately positioned and blocked out upper canine's and also significant lower anterior crowding – with obviously no improvement with his existing buccal occlusion. The father initially refused to have extractions, and hence a non-extraction approach was adopted and demonstrated the issues in this particular case – and later extractions were performed in order to improve his alignment and his occlusion.  We discussed the traditional question of what is the critical path to success---how would purely expansion correct the issues ? and also a discussion of risk management and how we would sequence and plan the best path for orthodontic care to this patient .

A further discussion was had as to whether lower extractions were required, and why we removed the lower second premolars in this case – but the possibility that a lower incisor extraction may have been even more appropriate to help resolve the crowding and allow lower anterior teeth not to  flare forwards   and obviously affect the amount of room that we required to retract the upper anterior teeth.

This was a wonderful learning case is so many different aspects of orthodontics was addressed and I hope you find this question and answer session to be a wonderful educational tool - and help take your orthodontic knowledge to another level .

As always we value your input, and please feel free to join us for on weekly live session at 7 AM Wednesday morning Melbourne time and please feel free to send me any comments, questions or cases that you would like to discuss geoff@orthoed.com.au

We look forward to helping you achieve more success with your orthodontics

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