extraction gaps

[Haya]

Hi everyone. . :-)
Its my first topic here .. I'll tell you briefly about my case I am a 25 years old female, before a year and nine months I got my braces on to fix my overbite it was not severe but I wanted to fix it, so my orthodontist extracted my upper first bicuspid one each side; now my front upper teeth are pulled back and there is noway to pull them back any more but the gaps of the extracted bicuspids didn't completely close I have about 3mm gap on my left side and about 2mm on the right side .. so the orthodontist told me that he will extract one of my lower bicuspid although my lower teeth are near perfect .. I am afraid that this extraction will ruin my lower teeth and leave me with another extra gaps on my lower jaw :-(
Can he get my upper back molars forward to close the gaps instead of extracting my lower bicuspid?
Thanks in advance
Sorry if my English was not perfect

[twentyseven]

Hello Haya. Welcome to the Board :)
From what I know bringing molars forward isn't always possible -I know that some orthos practice it with TADs but I am not sure whether this would be a feasible option for your particular case.
I would suggest getting another consultation, even though you are in the middle of your treatment. It's just better to know what other orthos might think of your case:)

[Haya]

Thanks alot twentyseven .. at the beginning of my treatment he mentioned that he might use tads if the gaps didn't fully close, before two months he said that he may shave my lower teeth to pull them back then pull the upper teeth back too, and on the last session he told me about the extraction , is this normal I mean shouldn't he know from the beginning what he will do across the process I feel that he always forget what he said before.
And if I consult another ortho and told me not to extract can I prevent the extraction and yet ask him for agood result, as he from the beginning told me that there is no need to extract any of my lower teeth and now he came with this strange idea
I am afraid :'(

[JumpTheDitch]

I had my upper bicuspids extracted to treat an overjet also. It wasn't the largest ever overjet but it was enough to bother me so off to the ortho I went. Retracting the uppers constituted the bulk of the treatment, but as the overjet was not huge, the gaps were partly closed with the molars coming forward, as pulling the uppers back a whole tooth-width would have been too far and given me an edge-on-edge bite. I can't comment on anyone else's case but it certainly seems it was possible in mine.

In terms of molars moving forward, it seems possible both in my original ortho's opinion and my current dentist's. In my first treatment the molars were 'allowed to come forward' into the remaining extraction gaps without any elastics, etc. Unfortunately my 'overjet' treatment didn't work out for me so well; I found out some years later after mounting health problems that my mandible had actually been retracted, and both TMJ discs were 'slipped' out of position. My current treatment involves reversing the retraction from my earlier treatment, and instead of implants for the extracted teeth, moving my molars forward into the gaps. This is will done without TADs, using interarch elastics, as well as encouraging the super-eruption of the lower molars with spacers to replace the molar build-ups currently preventing overclosing of the joint. I'm only partway through the process so far, having re-opened the gaps and dragged the first bicuspids forward, but so far so good. I don't know your personal circumstances but I would recommend getting other opinions. Good luck.

[JumpTheDitch]

For what it's worth I wanted to add, for my own situation I deeply regret having healthy teeth extracted. My initial consultation specifically ruled out any extractions. My ortho went as far as to bracket all my teeth, place the archwire and then changed his mind at last minute and suggested extracting the bicuspids. I figured he was the expert so I went along with it, thinking he knew best. Once it transpired that my mandible had been retracted, and several other dental/joint professionals suggested that possibly treating an overjet was not the course of action every orthodontist would have taken, I very much regrated diverging from the original written treatment plan which excluded extractions.

I'm not saying all extractions are bad, or that they cause problems for every person. But if your original assessment stated extractions were unnecessary, I personally would be very careful going ahead with such a permanent course of action. If you can find an ortho or dentist who follows a functional or neuromuscular approach, you can consult them to assess your current jaw-to-jaw relationship, and ascertain whether removing teeth would have a positive or detrimental affect on it. Only my 2c of course....