A CASE OF ADULT CROWDING TREATED WITH EXTRACTION OF THE MAXILLARY CANINES ANE MANDIBULAR FIRST PREMOLARS

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  • KATAOKA Yoko
    Department of Orthodontics, Showa University School of Dentistry
  • NAKANO Haruhisa
    Department of Orthodontics, Showa University School of Dentistry
  • MAKI Koutaro
    Department of Orthodontics, Showa University School of Dentistry
  • MIYAZAWA Yasusi
    Department of Periodontology, Showa University School of Dentistry
  • YAMAMOTO Matsuo
    Department of Periodontology, Showa University School of Dentistry

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Other Title
  • 上顎両側犬歯および下顎両側第一小臼歯抜去により治療を行った成人叢生症例
  • 症例報告 上顎両側犬歯および下顎両側第一小臼歯抜去により治療を行った成人叢生症例
  • ショウレイ ホウコク ジョウガク リョウガワ ケンシ オヨビ カガク リョウガワ ダイイチ ショウキュウシ バツキョ ニ ヨリ チリョウ オ オコナッタ セイジン ソウセイ ショウレイ

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Abstract

In cases of expedient tooth extraction for orthodontic treatment, the first premolar is chiefly extracted as the first line of treatment. However, when findings of periodontal disease, teeth with restorations and prostheses, and missing teeth are noted, it is necessary to determine which teeth should be extracted after careful investigation of the condition of the teeth and periodontal tissue. The patient was a 34-year-old [1]woman, whose chief complaint was crowding. Based on the examination, the patient was diagnosed with Angle class I skeletal mandibular protrusion with crowding of the maxillo-mandibular anterior teeth. Because gingival recession in the bilateral maxillary canines was noted, dentomaxillofacial cone-beam CT examination was performed to examine the condition of the alveolar bone, and optimal tooth extraction was evaluated. As a result, because alveolar bone resorption on the labial side of the maxillary canines was higher than that of the maxillary first premolars, we judged that the maxillary canines were preferable for expedient maxillary tooth extraction. Therefore, after completing the initial periodontal preparation, the bilateral maxillary canines and mandibular first premolars were extracted. Functional occlusion was established using a multi-bracket appliance, and a favorable occlusal relationship was achieved. However, as a result of dentomaxillofacial cone-beam CT examination at the time of the initiation of retention, the alveolar bone on the buccal side of the maxillary first premolars, which were arranged in the position of the maxillary canines, was thin. In adult orthodontic treatment, when the position for expedient tooth extraction is determined, it is considered important to not only understand the three-dimensional morphology of the alveolar bone at the time of the first examination, but also to sufficiently predict the morphology of the alveolar bone after extraction.

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