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Severe crowding : Is nonextraction treatment possible?

J Korean Dent Assoc > Volume 57(6); 2019 > Article
The Journal of The Korean Dental Association 2019;57(6):326-332.
Published online June 30, 2019.
심한 총생 : 비발치로 가능한가?
정민호
서울대학교 치의학대학원, 아너스치과교정과치과의원
Severe crowding : Is nonextraction treatment possible?
Min-Ho Jung
Department of Orthodontics, Seoul National University, HONORS Orthodontics
Abstract
Extraction treatment has been used for a long time to treat crowding or lip protrusion patients and still extraction decision is the most difficult and important decision during diagnosis and treatment planning. If the amount of crowidng is severe, premolar extraction is often considered. Because of their location, premolar extractions would seem to allow for the most straightforward relief of crowding and the improvement of soft tissue profile. But patients and their parents often prefer nonextraction approach if possible and such a preference gives us serious question about the boundary of nonextraction treatment. Because Orthodontic Mini-Implant (OMI) become popular these days, distalization of posterior teeth can be obtained easily without patient's compliance. For this reason, many orthodontists are trying to treat crowding patient with nonextraction than before. But sometime, unexpected side effects are observed including unesthetic profile, impaction of second molar and long treatment time. All the tools for space gaining - extraction, arch expansion, molar distalization and interproximal enamel reduction - have their limitations and indications. Possible side effects and limitations should be carefully considered during the treatment planning. Although Korean patients usually require extraction more often than US or European patients, more knowledge about the tools for space gaining would help us to decrease the rate of extraction and the problems during treatment of crowding patients.
Key Words: extraction;Orthodontic mini-implant;distalization;interproximal stripping;expansion;


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