© 2006 - The Charles H. Tweed International Foundation
© 2006 - The Charles H. Tweed International Foundation © 2006 - The Charles H. Tweed International Foundation
The Extraction/Nonextraction Dilemma – The Class I SolutionThe Class I solution is based upon the same thingsas the Class II solution except the “borderline” patient whohas a Class I dentition is diagnosed with two considerationsinstead of three. These two considerations are the face andthe tooth arch discrepancy. No anteroposterior problemexists so this problem does not have to be factored into thediagnosis. The diagnostic solutions for patients who have aClass I problem are:1. Extract third molars2. Extract second premolars3. Interproximal reduction4. A combination of 1 and 3JimVadenThe following patient, Figures 1-9 (Caitlin Brady),was treated with the extraction of mandibular third molars andFig. 1.Pretreatment facial photographsFig. 2. Pretreatment dental castsFig. 3. Pretreatment cephalometricFig. 4. Pretreatment cephalometric tracingsome minor interproximalreduction. It must bementioned here that patientswho are treated with thisdiagnosis must wear the highpull J-hook headgear to themandibular anterior teethso that these teeth are notflared and pushed forwardoff basal bone. The primarygoal of the orthodontist mustbe to hold the teeth in theirpretreatment position.Fig. 5.Pretreatment and posttreatment facial photographs31
Fig. 6. Pretreatment and posttreatment dental castsIf this is not done, some significantproblems will occur. There aretimes when this approach won’twork. The patient might be startedwithout removing teeth, but itsimply doesn’t work. There isnot enough space or the properforce system is not applied. Thedentition flares forward. Figures10-20 (Lindsey Gallaher) showthe records of a patient whosetreatment was started withoutpremolar extraction, but whosedentition flared forward off basalbone. Secondpremolars wereextracted andthe patient wastreated.Fig. 7. Posttreatment cephalometricradiographFig. 8. Posttreatment cephalometric tracingThediagnosis ofthese“borderline”patients and thetreatment planwhich followsmust becarefullyFig. 9. Superimpostion -Bradythought out priorto starting treatment. It is alsoessential that proper forces be appliedto the dentition at the proper time. Ina sense, these patients are much moredifficult to treat because very carefulattention to detail and to preservation oftooth position must be utilized duringthe course of treatment.Fig. 10. Pretreatment facial photographsFig. 11. Pretreatment cephalometric radiograph and tracing32
- 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 24 and 25: Fig. 5. B, Tracings: extraction of
- 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 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
<strong>The</strong> Extraction/Nonextraction Dilemma – <strong>The</strong> Class I Solution<strong>The</strong> Class I solution is based upon the same thingsas the Class II solution except the “borderline” patient whohas a Class I dentition is diagnosed with two considerationsinstead of three. <strong>The</strong>se two considerations are the face andthe tooth arch discrepancy. No anteroposterior problemexists so this problem does not have to be factored into thediagnosis. <strong>The</strong> diagnostic solutions for patients who have aClass I problem are:1. Extract third molars2. Extract second premolars3. Interproximal reduction4. A combination of 1 and 3JimVaden<strong>The</strong> following patient, Figures 1-9 (Caitlin Brady),was treated with the extraction of mandibular third molars andFig. 1.Pretreatment facial photographsFig. 2. Pretreatment dental castsFig. 3. Pretreatment cephalometricFig. 4. Pretreatment cephalometric tracingsome minor interproximalreduction. It must bementioned here that patientswho are treated with thisdiagnosis must wear the highpull J-hook headgear to themandibular anterior teethso that these teeth are notflared and pushed forwardoff basal bone. <strong>The</strong> primarygoal of the orthodontist mustbe to hold the teeth in theirpretreatment position.Fig. 5.Pretreatment and posttreatment facial photographs31
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