TREATMENT DECISION EXTRACTION VERSUS NON EXTRACTION.

On of the most important decision that we make daily in our orthdontic practice is whether to extract teeth or not in our patients.
Do not extract teeth unless you know that , that is the best way to treat the case.


TREATMENT GOALS.
· BALANCED SOFT TISSUE PROFILE.
· NON - EXTRACTION WHEN POSSIBLE.
· MANDIBULAR INCISORS UPRIGHT ON BASAL BONE.
· GOOD INTERINCISAL ANGLE.
· ROOT ARTISTIC POSITIONING.
· MANDIBULAR MOLARS UPRIGHT.
· CUSPIDS NOT EXPANDED.
· NORMAL OB, OJ.
· CLASS L CUSPIDS. FUNCTIONAL OCCLUSSION BALANCED OCCLUSSION.

TREATMENT DECISIONS.

Soft tissue profile.
· Convex ......................................extract
· class ll.
· normal.
· concave.......................................non extraction.

Periodontal condition.
· Normal ....................................non extraction
· compromised.
· Poor .......................................extraction.

Mandibular incisor position.
· Proclined. ........................................extraction
· Upright. ..
· Retroclined.. ......................................non extraction.

Arch length discrepancy.
· Mild.... .........................................non extraction.
· Moderate.
Severe..........................................extract.

Growth potential.
· Present
direction......low angle non extraction .....high angle extraction.
amount
· Border line.
· Past.

Co-operation and growth makes border line case non extraction.