CASE REPORT Fig. 32 Fig. 31 Fig. 33 retract the lower incisors for ante-rior crossbite correction. The following case presented specifically with a chief complaint of TMJ symptoms. Previous consultations ONLY offered her an orthognathic surgical treatment alternative. The case was success-fully treated with extraction of the lower 6’s, Class II elastics to de-compress the condyles (which initially made the Class III occlu-sion look worse), and lower intra-arch retraction mechanics for anterior crossbite correction. (Figs. 29-35) Which Teeth To Extract? Extraction of the lower 6’s is often the most optimal lower tooth to extract in a severe Class III case. The lower 6’s provides maximum space for A-P Class III correction and provide the maxi-mum space for lower constric-tion of the posterior mandibular arch. But extrac-tion of the lower 6’s is contingent on having good lower 3rd molar in shape and eruption posi-tion. Fortu-Fig. 34 nately, because Class III cases often have large mandibles, lower 8’s often have ample room to erupt in an acceptable position. A Class III case treated with extraction of the lower 6’s finishes looking non-extraction. It is disappoint-ing to look at a panoramic radio-graph of a Class III case only to discover the lower 3rd molars have already been extracted. Having them can be the differ-ence between a case being rela-tively easy or needing orthog-nathic surgery. This is a reason why no wisdom teeth should www.orthodontics.com Fall 2021 39
Journal of the American Orthodontic Society Fall 2021: Page 39
