Mandibular Incisor Extraction Research Articles

Bracketless fixed orthodontic treatment with mandibular incisor extraction

As an alternative to the conventional fixed appliance that uses orthodontic brackets, a simple tube without a bonding base can be bonded by covering it with flowable composite resin. However, bracketless fixed treatment has been limited to non-extraction cases because rigid archwires cannot be used. In this report, a 23-year-old female patient presented with the chief complaint of the reopening of the maxillary lateral incisor extraction space and the development of mandibular anterior crowding during retention. She was orthodontically treated with the extraction of the maxillary right and left lateral incisors and mandibular left central incisor nine years ago. Spacing at the maxillary extraction site and mandibular crowding developed due to the lingual fixed retainer bond failure. She was diagnosed as skeletal Class I with 1/4-cusp dental Class II. The extraction of the mandibular right central incisor was planned to relieve the mandibular anterior crowding and increase the required overjet for retracting the maxillary central incisors to close the spacing. Simple tubes were bonded to the teeth instead of brackets. Stainless steel retraction overlay archwires were used to close the extraction space and apply Class II elastics. Overlays worked as a rigid archwire, preventing the bowing effect. After treatment, favorable occlusion was achieved. This case report demonstrates that bracketless fixed orthodontic treatment with simple tubes can be applied to mandibular incisor extraction cases with the aid of a rigid overlay archwire.

Assessment of the outcomes and stability after mandibular incisor extraction in orthodontic patients: A systematic review and meta-analysis.

This study assessed the stability of the outcomes after mandibular incisor extraction (MIE) using intercanine width and peer assessment rating (PAR) scores in orthodontic patients. PubMed, Cochrane Library, Science Direct, Google Scholar, Ovid, and SciELO were systematically searched without restrictions until August 2022. A risk of bias assessment was performed using Newcastle-Ottawa Scale (NOS). The Grading of Recommendations, Assessment, Development, and Evaluation tool was used to assess the quality of evidence. Random effects meta-analysis was performed using RevMan software. Seven retrospective studies met the inclusion criteria and were included. Meta-analysis identified a statistically significant reduction in intercanine width with MIE after the retention period. The mean difference in post-retention changes concerning intercanine width (MD=0.14, 95% CI: -2.17-1.89; P<0.00001) was significantly higher in premolar extraction (PE) compared to incisor extraction and significantly less in non-extraction compared to incisor extraction (MD=0.72, 95% CI: -0.59-2.03; P<0.00001). Improvements in PAR scores from the start of treatment to the retention period indicated a high outcome standard (>70%) with MIE treatment, with no significant difference in the reduction percentage compared to premolar and non-extraction groups. With the existing retrospective studies of limited evidence, treatment outcomes with MIE were found to show good improvements in PAR scores. Some reduction in the intercanine width was evident after the retention period, which was observed even with the other two treatment modalities that were compared. Hence, with careful evaluation, MIE could be considered a valid treatment option.

TREATMENT OF CLASS I MALOCCLUSION WITH LOWER INCISOR EXTRACTION

The extraction of the lower incisor constitutes a therapeutic alternative in treating certain anomalies. It is not a standard approach to symmetrically treating most malocclusions, but in certain clinical situations the therapeutic aims must be adjusted to individual patient needs - even when this means that achieved final occlusion is not ideal. A case report is presented with one mandibular incisor extraction treatment of a 17 year-old male with a Class I malocclusion that shows a significant mandibular arch length deficiency and mandibular tooth-size excess. In this case, the degree of mandibular anterior dental crowding, existing mandibular tooth-size excess indicated the extraction of one mandibular incisor.

Invisalign Therapy in a Case of Mandibular Incisor Extraction

Clear aligners have been sought by patients as an aesthetic alternative to conventional orthodontic treatment. Despite the limitation that the aligner system offers, its use has improved over time. Hereby, authors discusses case of a 35-year-old female with Angle’s Class I malocclusion patient with severe mandibular crowding who was treated with mandibular incisor extraction using the Invisalign system. Clinical and radiographic examination revealed skeletal Class I malocclusion, severe crowding of the lower incisors, light crowding of the upper incisors, crossbite of the mandibular right canine, a convex profile, prominent lower lip, and a Bolton discrepancy in the lower anterior region. Fourteen trays were used in the maxillary arch and 28 in the mandibular arch. Two additional refinements, one with 13 and the other with 10 trays were delivered. After 2 years and 2 months of active treatment, good posterior occlusion and alignment of the teeth with adequate occlusion function and a balanced smile were achieved. The maxillary retainer was used continuously for 1 year, and at night until now. Successful tooth alignment and space closure were maintained, and the patient was satisfied with the results on the 2 year follow-up.

Comparison of treatment outcomes as assessed by 3 indexes in subjects with Class I malocclusion treated by 3 different methods: A cross-sectional study

Various treatment modalities exist to improve and correct Class I malocclusion. This study was conducted to evaluate the outcomes of nonextraction (NE), premolar extraction (PME), and mandibular incisor extraction (MIE) treatment modalities in subjects presenting with Class I malocclusion. A cross-sectional study was conducted at a tertiary care hospital using pretreatment and posttreatment dental casts along with intraoral photographs of 90 orthodontic subjects. These subjects were divided equally into NE, PME, and MIE groups and scored using the Index of Orthodontic Treatment Need, Index of Complexity, Outcome, and Need (ICON), and peer assessment rating (PAR) indexes. Nonparametric tests were run to compare pretreatment and posttreatment scores and to evaluate the percentage and categorical changes for the treatment modalities. Pairwise comparisons were performed using the Mann-Whitney U test. Statistically significant differences (P≤0.001) were seen between the pretreatment and posttreatment scores for all modalities. Statistically significant improvements were seen between the 3 treatment modalities for the PAR (P= 0.010) and ICON (P= 0.003) indexes. Significant categorical improvements were found for the Aesthetic Component (AC) (P= 0.012) among the 3 groups. Pairwise comparison revealed significant differences between the NE and MIE groups (ICON, P= 0.001; AC, P= 0.018) and PME and MIE groups (PAR, P= 0.002; ICON, P= 0.007; AC, P= 0.007). Posttreatment scores of all indexes were reduced, with significant differences found among the treatment modalities for all except the Dental Health Component index. The pairwise comparison revealed suboptimal occlusal results with the MIE group. Good occlusal and esthetic treatment outcomes were achieved with the PME and NE groups.

Unilateral Premolar Crossbite and Atypical Extraction Case Treated with Clear Aligner

A unilateral buccal crossbites can be observed in adult patients with skeletal asymmetry and crowded dentition. This case report describes the orthodontic treatment with clear aligners for a 57-year-old female with chin deviation, lower dentition crowding and a unilateral complete buccal crossbite in right premolars. Mandibular single incisor extraction was planned to relieve crowding and the crossbite was resolved by intrusion of upper premolar and uprighting of lower premolar with clear aligners in combined with inter-arch elastic. The entire treatment was completed within 20 months and the treatment result showed good vertical control. This case report demonstrates that clear aligners can be considered as an effective, esthetic, and comfortable tool for premolar crossbite correction, when the treatment sequence on ClinCheck® was designed properly. Also, one incisor extraction was a good option in specific case, especially when anterior Bolton discrepancy are larger than normal.

Delayed Eruption of Permanent Lower Lateral Incisor in Relation to Compound Odontoma: A Case Report

To report a delayed tooth eruption following late surgical removal of a compound odontoma in a 10-year-old child. Odontomas are the most common odontogenic tumors. They are usually asymptomatic and discovered during routine radiographic examinations or during an assessment of delayed tooth eruption. Odontomas are classified into compound or complex based on the microscopic structure of dental tissues. Early diagnosis and surgical removal of odontomas is the keyword for favorable results. This paper describes a case of compound odontomas in a 10-year-old boy that prevented eruption of the permanent mandibular lateral incisor. Extraction of mandibular primary lateral incisors and surgical excision of the compound odontomas was performed. After 3 years of follow-up, at the age of 13 years, the permanent lateral incisor erupted and approached the occlusal plane. Late surgical removal of odontomas resulted in a delayed eruption of the affected teeth. Surgical removal of odontomas and regular follow-up to monitor the eruption of the affected teeth should be considered for the teeth with an open apex before considering orthodontic traction.

The influence of 3x3 bonded retainer on anterior crowding relapse in mandibular incisor extraction cases.

ABSTRACTObjective: To evaluate the 3x3 bonded retainer influence on the mandibular anterior crowding in cases treated with mandibular incisor extraction Methods: The sample comprised pretreatment, posttreatment and follow-up orthodontic records of 16 subjects (10 females and 6 males) with Class I malocclusion treated with extraction of a single mandibular incisor. The mean ages (± SD) at pretreatment, posttreatment and follow-up evaluation were 23.45 ± 9.14 years, 25.50 ± 8.95 years and 30.11 ± 8.59 years, respectively. The mean (± SD) treatment time and posttreatment evaluation time were 2.05 ± 0.45 years and 4.60 ± 1.85 years , respectively. Little irregularity index and interdental widths were evaluated using dental casts. The sample was divided into two subgroups, according to the presence of the 3x3 bonded retainer at follow-up. Results: The subgroup without 3x3 bonded retainer presented a greater relapse at the follow-up, when compared to 3x3 bonded retainer subgroup.Conclusion: There was a significant relapse in cases treated with mandibular incisor extraction at follow-up. The subgroup without 3x3 bonded retainer showed a significant relapse at the follow-up when compared to the retainer group.

The Considerations Of Mandibular Incisor Extraction In Orthodontic Treatment: A Systematic Review

In orthodontics, extraction remains a controversial and multidisciplinary choice. In some instances, the understanding of the treatment outcomes and relapse rate has its importance. However, different literature needs to be assessed on the effectiveness of mandibular incisal extraction (MIE) among non-growing patients as an alternative treatment modality. This review was done following a particular focus question: &quot;Is mandibular incisor extraction being a common choice in orthodontic treatm

Is the only buccal infiltration anesthesia enough for extraction of mandibular anterior incisors and premolar teeth? A split-mouth randomized clinical trial

The issue of needing additional lingual injection in extractions of mandibular premolar and incisors is still not clarified. The aim of this study is to investigate whether it is necessary to perform lingual injection in addition to buccal infiltration anesthesia in mandibular incisors and premolar teeth extractions. Sixty-six patients who admitted to our clinic for the removal of bilateral mandibular anterior teeth were included in the present study. Patients were divided into two groups. The experimental group received only 1.5 ml of 2% lidocaine with 1:80,000 epinephrine by injection into the buccal vestibule of the tooth. The control group received 1.5 ml of 2% lidocaine with 1:80,000 epinephrine by buccal injection into the buccal side and 0.3 ml same lidocaine solution injected into the lingual side of the tooth. After 5 min, tooth was extracted and each patient was asked to record the intensity of injection and extraction pain by 0-100 mm and a 10-point Visual Analogue Scale (VAS) and six-pointed Face Pain Scale (FPS). The injection pain scores were significantly higher in terms of the VAS 0-10 point and 0-100 mm and FPS in the control group to which additional lingual injections were applied than the experimental group (p < 0.05). No statistically significant differences were found in all three scales between the groups in terms of extraction pain (p > 0.05). The mean extraction pain scores were lower in the experimental group according to the three scales. No additional anesthetic injection and post-operative complications were observed in all patients. The extraction of mandibular incisors and premolar teeth can only be done with only the buccal infiltration. In the extraction of mandibular anterior teeth, it can be performed with less anesthetic amount without the need for an additional lingual injection.

Histological Study of Socket Healing after Tooth Extraction in Rabbits Treated with Short Term Diclofenac Sodium (Expermintal Study)

Aims: The aim of the present study is to investigate if short term therapy with diclofenac sodium of interferes with the time course of alveolar wound healing in rabbits. Materials and Methods: The sample included twelve rabbits; 6 rabbits received interamuscular injections of diclofenac sodium (10 mg/kg/day), one day before extraction, at a day of extraction and 4 days after extraction of the right mandibular incisors and 6 rabbits received interamuscular injections of normal saline. The animals were sacrificed in each group at 7, 14 and 21 days after tooth extraction. Results: The present results showed that the effect of diclofenac treatment caused no signifcant decrease in bone formation of socket healing. Conclusion: Histological study of short term therapy with diclofenac sodium after tooth extraction caused non-significant decrease in bone formation of extraction sockets healing in rabbits.

Class III malocclusion camouflage treatment in adults: A Systematic Review

Objective: To evaluate the effects of camouflage treatment of Class III malocclusion in adults. Methods: An electronic search was performed in MEDLINE/PubMed, Embase, Scopus, Web of Science, Google Scholar, Lilacs, and Cochrane databases, without limitations regarding publication year or language. Studies evaluating nongrowing individuals with Class III malocclusion undergoing orthodontic camouflage treatment with any orthodontic technique, including extraction and non-extraction approaches, were considered. Study selection, data extraction, and risk of bias assessment according to a modified Downs and Black checklist were performed by two independent reviewers. A third evaluator was included if disagreements emerged. Results: Nine studies were included in the review. Eight presented high risk of bias. Different methods for Class III malocclusion correction were described and included maxillary and mandibular premolar extractions, mandibular incisor extraction, Class III elastics and distalization of the mandibular dentition. Extractions in the mandibular arch resulted in lingual tipping and retrusion of the mandibular incisors, and labial tipping and protrusion of the maxillary incisors. The use of Class III intermaxillary elastics promoted proclination of the maxillary incisors, extrusion of the maxillary molars, distal tipping of the mandibular molars, extrusion of the mandibular incisors, and clockwise rotation of the mandible. Distalization of the mandibular dentition resulted in distal tipping of the mandibular molars, retroclination and retraction of the mandibular incisors, and counter clockwise rotation of the mandible. Conclusions: Treatment changes are influenced by the method used to correct the Class III malocclusion and are primarily dentoalveolar

A New Technique for Research on Wound Healing through Extraction of Mandibular Lower Incisors in Wistar Rats.

Objective The aim of this study was to explain a new technique for research on wound healing through extraction of mandibular lower incisors in Wistar rats. Materials and Methods Fifty Wistar rats were used from studies using the experimental animal to investigate the effects of wound healing drugs on alveolar bone. The mandibular incisors of the Wistar rats were extracted using a special modified bein and special pulling pliers under general anesthesia. The tooth socket after extraction was closed using a 5.0 suture nylon needle. Results The results of this technique used in this extraction showed 2% incisor tooth fracture and 3% bleeding, and that all fractured teeth could be removed properly, and bleeding could be stopped after suturing. Conclusion The new techniques we use can be useful for research on mucosal and alveolar bone healing, specifically finding new types of drugs to accelerate wound healing after alveolar bone post extraction.

Indications of Single Mandibular Incisor Extraction and Assessment of the Results in Orthodontics

Indications of Single Mandibular Incisor Extraction and Assessment of the Results in Orthodontics

Treatment of a Severe Tooth Size-arch Length Discrepancy Using Rapid Maxillary Expansion and Mandibular Incisor Extraction: An Unconventional Combination Approach

Treatment of a Severe Tooth Size-arch Length Discrepancy Using Rapid Maxillary Expansion and Mandibular Incisor Extraction: An Unconventional Combination Approach

Treatment of a Severe Tooth Size-arch Length Discrepancy Using Rapid Maxillary Expansion and Mandibular Incisor Extraction: An Unconventional Combination Approach

Treatment of a Severe Tooth Size-arch Length Discrepancy Using Rapid Maxillary Expansion and Mandibular Incisor Extraction: An Unconventional Combination Approach

Improvement in Peer Assessment Rating scores after nonextraction, premolar extraction, and mandibular incisor extraction treatments in patients with Class I malocclusion.

Different treatment protocols implemented for correction of Class I malocclusion aim at achieving ideal occlusal characteristics. This study was planned to evaluate the improvement in the occlusal characteristics of Class I patients treated with nonextraction (NE), all first premolar extractions (PME), and mandibular incisor extraction (MIE) as assessed by the percentage of improvement in Peer Assessment Rating (PAR) scores. This retrospective cross-sectional study was conducted on the pretreatment and posttreatment dental casts of 108 subjects with Class I malocclusion. The total sample was divided into 3 equal groups according to the treatment protocol implemented: NE, PME, and MIE. The mean pretreatment and posttreatment PAR scores, and the percentages of improvement were compared among the 3 treatment modalities using Kruskal-Wallis and post-hoc Dunnett T3 tests. The mean percentages of improvement in the PAR score were 75.8%±25.8% in the NE group, 73.1%±19.4% in the PME group, and 70.6%±24.1% in the MIE group. There was no significant difference (P=0.351) in the percentages of improvement in PAR scores among the 3 treatment modalities. However, the mean pretreatment and posttreatment PAR scores varied significantly (P<0.001) in the 3 groups. The average pretreatment and posttreatment PAR scores were highest in the MIE group and lowest in the NE group. The comparable percentages of improvement in PAR scores among the 3 groups denote that equivalent occlusal corrections were achieved in Class I patients treated with the NE, PME, and MIE protocols.

Lower incisor extraction as an orthodontic treatment option: A case report

Incisor extraction in orthodontics treatment has been one of the options since there are very few patients who are considered for such treatment. Proper and detailed diagnosis should be done so that good results can be obtained. A case report of a 20 year old female is presented who has Class II, Division 1 malocclusion with crowding in the lower arch. Keywords: Mandibular Incisor Extraction Orthodontics, Crowding

Treatment of Class I malocclusion by single mandibular incisor extraction in patient with class III skeletal base – A case report

Over the long time, increasing numbers of patients have become aware of orthodontic treatment and are demanding high-quality treatment, in the shortest possible time with increased efficiency and reduced costs. Orthodontic treatment aims at normal functional occlusion balance with the supporting structures and environmental musculature. Class I malocclusions can be treated by several means, according to the characteristics associated with the problem, such as tooth material-arch length discrepancy, patient’s profile, and dentition as a whole in relation to the cranial base determines teeth to be extracted as well as patient compliance.(1) Correction of Class I malocclusions in non-growing patients usually involves selective removal of permanent teeth, with subsequent dental camouflage. Keywords: Class I malocclusion, Single mandibular incisor extraction, Class III skeletal base

Treatment of an adult with a normodivergent, mild skeletal Class III pattern, and a Bolton's discrepancy using a single mandibular incisor extraction plan

Treatment of an adult with a normodivergent, mild skeletal Class III pattern, and a Bolton's discrepancy using a single mandibular incisor extraction plan