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Fig. 5. B, Tracings: extraction of maxillary first premolars and mandibularsecond premolars (pretreatment-left; posttreatment-right).nonextraction group finished treatment with a Z-angle 8.12° greaterand an E-value 2.59 mm more negative than did the four firstpremolar extraction subgroup.CONCLUSIONS1. Both the extraction and nonextraction group facial profileFig. 5. A, Facial photographs: extraction of maxillaryfirst premolars and mandibular second premo-treatment.value averages were within the normal range at the completion oflars (pretreatment-left; posttreatment-right). 2. The average posttreatment lip profile position of thenonextraction group was slightly more retrusive than that of the extraction group.3. The extraction group had greater pretreatment facial imbalances.4. The extraction group had the greatest improvement in facial balance.5. In all patients in the extraction group, the common denominator “chin prominence” either remained in balance or wasimproved.6. The smiles in both groups were balanced and pleasing except for a few patients who had vertical skeletaldisharmonies.7. With a sound diagnostic scheme, treatment plan, and management of extraction space, extraction of the proper teethcan create balanced facial esthetics, not destroy it.Evaluation of facial profiles and facial balance is a constant, continuous, lifelong study and learning process fororthodontists. Tooth movement and proper positioning of the teeth to ensure favorable facial changes and to avoidunfavorable changes should be in the orthodontist’s “diagnostic” mind from the very first examination. To treat patientsnonextraction for the sake of not removing teeth, ease of treatment, or the dictates of an appliance is not sound reasoningand makes as much diagnostic sense as treating all patients with the extraction of all four first premolars. In other23
words, it is just asdiagnostically wrongto treat an extractionpatient nonextractionas it is to treat anonextraction patientwith extractions. Thetruth lies somewhere inbetween and is basedon a sound quantifiedmeasurement analysis,differential evaluation ofthe problem, and clinicalassessment.Fig. 6. A, Facial photographs: extractionof four first premolars (pretreatment-left;posttreatment-right).Fig. 7.A, Facial Photographs: nonextraction,average posttreatment Z-angle (pretreatmentleft;posttreatment-right).REFERENCESFig. 6. B, Tracings: extraction of four first premolars (pretreatment-left;posttreatment-right).Fig. 7. B, Tracings: nonextraction, average posttreatment Z-angle(pretreatment-left; posttreatment-right).1. Angle EH. Malocclusion of the teeth andfractures of the maxillae. 6 th ed. Philadelphia: SSWhite Dental Mfg Co; 1900; p.15-23.2. Angle EH. Malocclusion of the teeth. 7 th ed.Philadelphia: SS White Dental Mfg Co; 1907.3. Tweed CH. Clinical orthodontics. Vol 1. St.Louis: Mosby; 1966. p. 31-82.4. Downs WB. Variations in facial relationships:their significance in treatment and prognosis. AmJ Orthod 1948; 34:812-40.5. Holdaway RA. A Soft tissue cephalometricanalysis and its use in orthodontic treatmentplanning. Part I Am J Orthod 1983; 84:1-28.6. Ricketts RM. Cephalometric synthesis. Am JOrthod 1960; 46:647-73.7. Ricketts RM. Perspectives in the clinicalapplication of cephalometrics. Angle Orthod1981; 51:115-50.8. Merrifield LL. The profile line as an aid incritically evaluating facial esthetics. Am J Orthod1966; 52:804-22.24
Page 1 and 2: © 2006
Page 5 and 6: Chairman of the Board Report 2006Ja
Page 7 and 8: Tribute: Dr. Herbert A. Klontz, Twe
Page 9 and 10: He was not only generous in Toronto
Page 11 and 12: Director of Education — Herb Klon
Page 13 and 14: Orthodontic Treatment of a Low Angl
Page 15: Fig. 5. McNamara’s NasionFrankfor
Page 19: REFERENCES1. Horn AJ. Facial height
Page 22 and 23: The more protrusive the lip profile
Page 26 and 27: The Extraction/Nonextraction Dilemm
Page 28 and 29: Fig. 6. Baxter’s posttreatment ce
Page 30 and 31: Fig. 16. Adams’ posttreatment cep
Page 32 and 33: The Extraction/Nonextraction Dilemm
Page 34 and 35: Fig. 12. Pretreatment dental castsF
Page 36 and 37: Microimplant Anchorage (MIA) in Ort
Page 38 and 39: Recently, with the rapid developmen
Page 40 and 41: Fig. 5. Molar intrusion: A) Maxilla
Page 43 and 44: Two Phase Treatment for Deep Bite P
Page 45 and 46: Fig. 7a. Post orthopedic cephalomet
Page 47: References:1. Dale J.G.. Longitudin

Â© 2006 - The Charles H. Tweed International Foundation

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