2015 AAO Winter Conf - The Case for Non-extraction in the Mixed Dentition / Extraction in the Mixed Dentition -- A Reasonable Option for Selected Patients? / The Impact on Stability and the Face

Point/Counterpoint: The Case for Non-extraction in the Mixed Dentition

This presentation will discuss the findings of a series of prospective and retrospective clinical studies of orthodontic and orthopedics intervention in the early mixed dentition. Guidelines will be presented as to which patients will benefit from treatment with a bonded rapid maxillary expander, preceded in some instances by a removable lower Schwarz expansion appliance. Other patients, especially those with large tooth size, will benefit from a serial extraction protocol. In managing tooth-size/arch-size discrepancies in the mixed dentition, common sense must prevail.

Learning Objectives:

• Relate the indications for the use of a bonded acrylic splint expander
• Determine which patients will benefit from removable Schwarz treatment
• Recognize which patients can be treated non-extraction and which patients require extraction of permanent teeth

Point/Counterpoint: Extraction in the Mixed Dentition — A Reasonable Option for Selected Patients?

This lecture will discuss a bit of the history of the extraction/nonextraction controversy, which will focus on extraction of deciduous and then permanent teeth in the mixed dentition. The case reports used to illustrate this lecture have significant tooth arch length discrepancies that required the removal of dental units in order for the patient to have an esthetic, healthy, functional and stable dentition.

Learning Objectives:

• Recognize the malocclusion that might require removal of dental units during the mixed dentition phase of dental development
• Identify selected teeth that should be considered for removal at a particular age
• Evaluate a patient who has tooth arch length discrepancies for possible extraction in the mixed and/or early permanent dentition

Extraction/Non-extraction: The Impact on Stability and the Face

The decision to treat with or without extractions is a treatment decision that should be based on specific, evidence-based facial, skeletal and dental treatment objectives. This lecture will explore two critical components of specific treatment objectives, facial esthetics and stability, and how the decision to extract or not impacts both.

Learning Objectives:

• Define the ideal range of facial esthetic treatment goals
• Determine the treatment approach that maximizes facial esthetics and stability