"MAnY CAn SiTE CASES whERE PRofilES wERE unDouBTEDlY CoMPRoMiSED BECAuSE of inAPPRoPRiATE EXTRACTion of BiCuSPiDS. BuT AlMoST AnYonE wiTh noMinAl EXPERiEnCE hAS TREATED A CASE (oR CASES) non-EXTRACTion AnD REgRETTED ThEiR DECiSion." patient was treated non-extraction and Fig. 2c shows the final profile after the patient was treated with four bicuspid extractions. ᕡ Poor profiles that are concave ᕢ Deep bite complications ᕣ Increase in gingival display ᕤ Failure to correct A-P discrepancy (or Cl II gets even worse!) ᕥ Incomplete extraction space closure ᕦ Root resorption as retro-clined upper incisors impinge on the buccal cortical bone Fig. 3 PRoBlEMS wiTh BiCuSPiD EXTRACTion TREATMEnT Poor Diagnosis and treatment planning in cases that have extraction of four bicuspids can result in disastrous outcomes including: These mistakes are the result of many faulty assump-tions about diagnosis. The Steiner analysis was based on a sample size of ONE patient…his Daughter. Other cephalometric edicts about where the “Correct” or “ideal” lower incisor position are based on a sample size of five adult females. This remains the basis for many Fig. 4 Fig. 5 www.orthodontics.com Spring 2018 17
Journal of the American Orthodontic Society Spring 2018: Page 17
