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Extractions Contreversies in Orthodontics

Indications Part 1

M. ABOULNASER- Orthodontist, BAU, USA.


O. SANDID- Orthodontist, D.C.D., D.U.O, C.E.S.B.B, C.E.S.O.D.F ,
S.Q.O.D.F, Ex charg de cours, Paris. France.

Contact: dr.aboualnaser@hotmail.com

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Time 30 minutes

Extractions Contreversies in
Orthodontics
Indications Part 1
M. ABOUELNASER

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Time 30 minutes

Les bnfices du traitement orthodontique


Benefits of Orthodontic Treatment.
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Du Sourire,

Le praticien espre obtenir:


Une Amlioration Esthtique
Du Profil rtrusif,
Ou prognathique

Une Amlioration Fonctionnelle


De locclusion,
Du parodonte,

De lATM

Extraction versus Non-Extraction


Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Edward Angle

Charles Tweed

Le dbat dure depuis plus de 100 ans, et ca continue, cest le sujet le plus de
controvers en
Orthodontie
E. Angle le pre de l'orthodontie croyait fermement dans le traitement nonextraction.
C. Tweed, a observ que certains patients traits par Angle prsentaient une
quantit notable de rcidives, a retrait un certain nombre de ces cas en extrayant
quatre prmolaires, pour plus de stabilit
Bousaba S,Delatte M,De Clerck H. Rev Belge Med Dent (1984).1995;50(2):53-65.

Extraction versus Non-Extraction

Part 1: Extraction in Orthodontics and its Indications.


Part 2: Non-extractionPhilosophy, Space regaining.
Part 3: Choice of teeth for extraction.

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Extractions in Orthodontics
Indications

1-Indications: Severe dental crowding > 7mm-Tooth-arch discrepancy


2-Indications: Anteroposterior relationships discrepancy.
3-Indications: unfavorable position of Tooth impaction, Dental ankylosis.
4- Indications: unaesthetic facial profile, Protrusion.
5- Indications: Adult crowding with gingival recession.
6- Indications: Dental Caries.
7-Indications: Supernumerary teeth
8- Indications: Patients not motivated and we need to shorten duration of
treatment.
9-Indications: Hyperdivergent facial type vertical growth pattern.

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

1-Arch length- Severe Dental Crowding > 7mm


Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Tooth-arch discrepancy: Size of the jaw is smaller than the size of the
teeth
Dental crowding can be simply defined as the overlap of teeth caused
by insufficient space within the dental arch.
If the dentition is too large (Macrodontia) to fit in the dental arch
without irregularity, it may be necessary to reduce the dentition size by
the extraction of teeth.

2-Indications: SevereSkeletalClass II
Correction of Occlusion Reduce overjet
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Anteroposterior relationships ( Problem in patient cooperation, elastics, functional


appliances, headgear )
Overjet is also known as protrusion of teeth, the lower teeth are too far behind
the upper front teeth.
In most Class II cases with abnormal upper proclination, it is advisable to extract
teeth (14-24) only in the upper arch and to retract the maxillary incisors and
canines. In case of the lower arch crowding it is advisable to extract in both the
arches (34-44).

2-Indications: Severe skeletal Class III


malocclusion Reduce Reverse Overjet
www.orthofree.com

REVERSE OVERJET IMPORTANT Class III cases are


usually treated by extracting teeth only in the lower arch to
discourage the forward growth of mandibe (34-44)
Or surgery (15-25-34-44)
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

2-Dcalage des bases osseuses- Classe III squelettique- Overjet invers


Skeletal Class III malocclusion- Reduce Reverse Overjet
www.orthofree.com

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Dans le cas de Classe III squelettique, les extractions sont


envisageables pour Rduire le surplomb invers, Extractions
de ( 34-44) ou ( 34-44 et 15 et 25 ).
Diego Rey Mora, Giovanni Oberti,PROGRESSinORTHODONTICS

2-Indications: Severe Openbite, hyperdivrgent


Reduce Openbite- Reduce lower facial height

Before Trt

After Trt
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

2- Svre Bance, hyperdivergence


Severe Openbite, hyperdivrgent
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Cas De Svre Bance, Hyperdivergence, Les Extractions Entrane Une


Rduction De La Bance Et une Diminution De Ltage Inferieur De La Face

Avant Trt

Apres Trt

www.orthofree.com

2-Indications: Midline correction, Dental asymmetry

Correction of Occlusion, Dental asymmetry,


Midline correction

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

2-Correction des asymtries et de la ligne mdiane


Midline correction, Dental asymmetry

Guilherme JANSON, Jos Eduardo Prado de SOUZA, J Appl Oral Sci. 2009;17(4):354-63

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

3-Impacted teeth - unfavorable position


Impacted Canine, Root Proximity, Root resorption
Unfavorable position

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

3-Impacted teeth - Unfavorable position


Impactedmolars, Root Proximity, Root resorption

Unfavorable position
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

3-Indications: Dental ankylosis

Tipping of teeth toward the ankylosed tooth and we need surgical intervention.

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

4-Biprotrusion - Convex Profile


Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Before Trt

After Trt

LIP POSITION: Incisor inclination

Biprotrusion
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Reduce Biprotrusion, Gingival recession

Before Trt

After Trt

J Canon orthofree.com

4-Protrusive profile and gingival recession, lower


incisor inclination on mandibular plane.
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

4-Position de l'incisive infrieure par rapport au plan


mandibulaire, soutien osseux
Lower incisor inclination on mandibular plane 90.

90

Quand on ne peut pas vestibuler incisive infrieure, tissu de soutien faible


Nous envisageons un traitement par extractions ,
La Position de l'incisive infrieure par rapport au plan mandibulaire nous donne des indications sur la
ncessite ou non dextraire , on compare cela une personne qui avance sur un balcon au au-del
decertaines limites la personne risque de tomber
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

www.orthofree.com

Cas traite sans extraction


Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Avant trt
10 ans aprs traitement
Un cas clinique que jai trait il y a 17 ans, Noter que une occlusion parfaite mais des
rcessions gingivales observes
O. Sandid

Agenesis compensation
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

6-UNHEALTHY TOOTH

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

6- Indications: Caries, Decay

6-Delabrement dentaire-Caries
Unhealthy tooth
Extraction des dents caries et prferable est indique
dans le plan de traitement orthodontique

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

7-Supernumerary teeth

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

8-Patients motivation
Indications: Patients not motivated- shortening duration
treatment, headgear wear, missing appointments

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

8-Manque de coopration et de motivation du patient


Patients not motivated
Le manque de motivation du patient: Non port des
lastiques, des forces extra-orales , des appareillages
fonctionnels etc

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Serial extraction
Guidance of Eruption

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Traitements interceptifs -Guidage de lruption


Early Treatment - Guidance of Eruption
Le Guidage de lruption: Lextraction prcoce des canines lactales et dans certains
cas des premires molaires lactales, permet dviter linclusion des canines,
Do lintrt des traitements prcoces interceptifs .

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Retard d ruption des dents dfinitives


Delayed eruption of permanent teeth
Extraction de dents lactales quand il y a Retard d ruption des
dents dfinitives

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Retard d ruption des dents dfinitives


Delayed eruption of permanent teeth
Une patient sest prsent a lge de 8 ans, retard druption, la panoramique
Montre lexistence de dents surnumraires , do lindication des extractions afin de
Guider l ruption des dents dfinitives

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Non Extraction

Extraction
Profil Concave
Convexe

Avant de dcider le traitement par extractions il faut tenir compte


du profil et de la typologie de croissance du patient

Typologie faciale
Hypodivergent
hyperdivergent
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Non Extraction

Extraction

Position de lincisive
infrieure
Etat parodontal

Avant de dcider le traitement par extractions il faut tenir compte de la position


de lincisive infrieure, l tat parodontal, et la prdisposition a lapne du
sommeil
Apne du sommeil
Permabilit des
voiesariennes
suprieures

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Non Extraction

Extraction

Stabilit
traitement
orthodontique,
Rcidive

Penser la stabilit du traitement et au facteurs de rcidives ainsi que de la


possibilit denvisager une rduction amlaire proximale
ou stripping, en fonction de la forme coronaire

Rduction amlaire
proximale,
Stripping, Formes
des couronnes
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Non-extraction Orthodontictherapy
Part 2

Dr M. ABOUELNASER

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Non-extraction Orthodontictherapy
1-Transverse Control, Expansion
2-Sagittal Control, Reduction of overjet.
3- Levelling of the curve of Spee on the proclination of
mandibular incisors and expansion of dental arches
4-Molar distalization
5-Stripping: Reduction of proximal enamel.
6-Vertical Control: Unblocking of mandibular growth.

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Non-extraction Orthodontictherapy
Transverse Control
ExpansionGingival recession-Stabilty ?

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Dr. Greenfeld orthofree.com

Non-extraction Orthodontictherapy
Transverse Control
Expansion

Quadhelix

Rapid Palatal Expander(RPE)

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

2-Sagittal Control- Overjet reduction


Functional appliance

Early treatment , Bone Growth Stimulation, stop growing


Benefits of early treatment stimulate mandibular growth and blockageof maxilla, reduce
overjet and treatment without extraction.

O.SANDID
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

2-Sagittal Control- Overjet reduction


IntermaxillaryClass II elastics

O.SANDID

Frankel functional regulator

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

2-Sagittal Control- Overjet reduction

IntermaxillaryClass II elastics- Cooperation

IntermaxillaryClass II elastics

O.SANDID

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Impacted Maxillary Canine


Open space

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Maxillary canine impaction

Molars distalization

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

O.SANDID

Facial Mask- Cooperation

O.SANDID
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Vertical Control
Unlocking growth of mandible

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

O.SANDID

Levelling of the curve of Spee on the proclination


of mandibular incisors

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Levelling of the curve of Spee on the proclination of mandibular incisors

Respect angulation of lower incisors on mand plane (Tweed triangle)

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Levelling of the curve of Spee by the proclination of


mandibular incisors and expansion of dental arches

http://simpliclearpro.com
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Molar distalization- Cooperation

Headgear

Pendulum

Mini-implant

Lip Bumper

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Tooth Stripping" - Interproximal enamel reduction

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Le dblocage de la croissance mandibulaire


Unblockingofmandibular growth
Le dblocage de la croissance mandibulaire permet a la mandibule de s
panouir en vitant lencombrement dentaire, et linstallation de la
rtrognathie mandibulaire, do lintrt des traitements interceptifs

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

O.SANDID

Correction Oral Habits

Swallowing Pattern

swallowing pattern
Finger Sucking

Mouth breathing

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Extractions Contreversies in
Orthodontics
Part 3: Choice of teeth for extraction.
M. ABOUELNASER

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

CHOICE OF TEETH FOR EXTRACTION

1st Upper Premolar Extraction


Extraction of two lower premolars
Extraction of 4 premolars
Lower incisor extraction
First molars extractions
Wisdom teeth extractions
Tooth impaction Extraction
Unfavorable position
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Choice of teeth for extraction.

1st Upper Premolar Extraction in Orthodontics- 51%

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Camouflage treatment in adult skeletal Class III cases by


extraction of two lower premolars
Extraction of two lower premolars

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Crowding- Extractionof4 premolars


www.orthofree.com

Extractionof4 premolars 11%

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

M.DMCNUTT

Crowding- Extractionof4 premolars


www.orthofree.com

Extractionof4 premolars 11%


15-25-34-44

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

M.DMCNUTT

Crowding- Extractionof4 premolars


Extractionof4 premolars
15-25-35-45

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

M.DMCNUTT

Orthodontic treatment with lower incisor


extraction
.

Overeruption and attachment loss of tooth 31.

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

KenzaLAHLOUAalloulaELHOUSSAINE

First molars extractions

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

DrLemay-http://www.orthodontisteenligne.com/blogue/extractions/

Second Molar Extraction

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Wisdom teeth extractions (7%)

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Impacted Maxillary Canine-Extraction

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

\
Traitements orthodontique sur des vrais jumelles
Twins treated by different orthodontic techniques.
Dr Alan Bagden

Dr Bagden a expriment 2 traitements sur des vrais jumelles avec et sans extractions,
rsultats, profil est concave pour le cas trait avec extractions

Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Relation entre extractions dentaires et lapne du sommeil ?


Relationship BetweenExtractions andSleep Apnea ?
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Extractions en orthodontie et constriction des arcades dentaires, Le


volume destin a loger la langue a t rduit, pas suffisamment dtudes
pour quantifier lincidence sur la permabilit des voies ariennes
suprieures , tout dpendra sil y a msialisation des dents vers le site
dextraction ou recul du bloc incisivo- canin ?

Extractions et dure de traitement


Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Les extractions en orthodontie


reduisent - Elle la dure du
traitement ou la rallonge ?
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

http://www.dr-alexandrian-stella.chirurgiens-dentistes.fr/les-conseils-de-lorthodontiste/un-traitement-en-orthodontie-dure-combien-de-temps

Conclusion
Extractions in Orthodontics- oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser

Plus japprends moins je sais ?


Je sais que je ne sais rien, mais je le sais!
Socrate

EXTRACTIONS

Compromis

Non Extraction

Prsentation en anglais
sur
www.orthofree.com
www.slideshare.net

Bibibliographie
1. Aras A. Class II correction with the modified sagittal appliance and maxillary second
molar extraction. Angle Orthod. 2000 Aug;70(4):332-8.
2. Basdra EK, Komposch G. Maxillary second molar extraction treatment. J Clin Orthod.
1994 Aug;28(8):476-81.
3. Basdra EK, Stellzig A, Komposch G. Extraction of maxillary second molars in the
treatment of Class II malocclusion. Angle Orthod. 1996;66(4):287-91.
4. Bishara SE, Burkey PS. Second molar extractions: a review. Am J
Orthod. 1986 May;89(5):415-24.
5. Cavanaugh JJ. Third molar changes following second molar
extractions. Angle Orthod. 1985 Jan;55(1):70-6.
6. Chapin WC. The extraction of maxillary second molars to reduce
growth stimulation. Am J Orthod Oral Surg. 1939;11:1072-8.
7. Chipman MR. Second and third molars: their role in orthodontic
therapy. Am J Orthod. 1961 Jul;47(7):498-520.
8. Graber TM. The role of upper second molar extraction in
orthodontic treatment. Am J Orthod. 1955;41:354-61.
9. Graber TM. Maxillary second molar extraction in Class II
malocclusion. Am J Orthod. 1969 Oct; 56(4):331-53.

Extractions in Orthodontics
www.orthofree.com

Bibibliographie
10. Haas AJ. Lets take a rational look at permanent second molar
extraction. Am J Orthod Dentofacial Orthop. 1986 Nov;90(5):361-3.
11. Harnick DJ. Case report: Class II correction using a modified
Wilson bimetric distalizing arch and maxillary second molar
extraction. Angle Orthod. 1998 Jun; 68(3):275-80.
12. Henriques JFC, Janson G, Hayasaki SM. Parmetros para a
extrao de molares no tratamento ortodntico: consideraes
gerais e apresentao de um caso clnico. Rev Dental Press Ortod
Ortop Facial. 2002 jan-fev;7(1):57-64.
13. Jger A, El- Kabarity A, Singelmann C. Evaluation of orthodontic
treatment with early extraction of four second molars. J Orofac
Orthop. 1997 Feb; 58(1):30-43.
14. Jones H. Second molar extraction therapy - two case reports.
Funct Orthod. 2000 Winter;17(1):17-20.

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