Recently, more studies into existing extraction protocols have shown that this technique does not always yield very stable results, leading many to believe that it is unnecessary to sacrifice teeth. Studies conducted by Witzig and Spahl, and Dierkes suggest that extraction of the four first premolars will compromise esthetics by dishing in the profile. This has produced a trend back toward non-extraction/expansion models bringing the debate to a full circle.
Expansion vs Extraction
There are 2 major reasons to extract teeth: First is to Extract for Space, in order to alleviate crowding and second is to Extract for face, to reduce protrusion or to camouflage skeletal Class II or Class III malocclusion. Dental crowding can also be corrected without tooth extraction by expanding the dental arches. But prior to deciding whether to do dental extraction or arch expansion, several factors should be considered in planning any orthodontic treatment.
Bernstein L, Angle EH, Case CS (1992): Extraction vs Nonextraction, Part I. Historical Revisionism, AJODO, 102 (5)
Spahl TJ, Witzig JW (1987): The Clinical Management of Basic Maxillofacial Orthopedic Appliances, Vol. 1 Mechanics. Littleton Mass PSG Publ Co.
Dierkes JM (1987): The Beauty of the Face: An Orthodontic Perspective, J Am Dent Assoc (Special Issue) 89E-95E.
Josievitz U Tan Zafra DMD
Decision Making in Orthodontics
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