PROPHYLACTIC REMOVAL OF THIRD MOLARS IN ORTHODONTICS

Eruption of the third molar teeth representing completion in formation of entire tooth. But a lot of observer have a notion that, pressure eruption of the third molar will generate mesial pressure at tooth in front of its and can cause overcrowding. The influence of the third molar to anterior regio have been percieved by Scawarze in 1973. Mesial presure can influence efficacy of orthodontics treatment, this matter is can be seen from the sign of early return of crowding incicivus tooth after finishing treatment orthodontic. Repeal of profilaksis the third molar for the reason of orthodonti treatment have been sugested ( Andersen, 1935). Cases which have been evaluated to 500 patient, found that 22,6 % the third molar of maxilla and 22,5 % mandibula are axtracted in order to orthodontic treatment. The age suggested took a fancy is 14 - 16 year. Repealing of the tooth expected can discontinue presure to mesial is which still going on during period of child growth. Prevention of relapsing treatment resault orthodonti represent main reason for repealing of the tooth.

EXTRACTING SECOND MOLARS IN ORTHODONTICS TREATMENT

An important reason for elective extractions in orthodontics is the relief of crowding. First premolar teeth provide up to 14 mm of space for the relief crowding. Second molar teeth can provide some 18 – 22 mm of space, of which is made available to the relief of crowding in the lower labial segment where crowding most often occurs.
The advantages extracting second molar include, Less detrimental to facial profile, Facilitates the eruption of third molars, Spontaneous relief of crowding in the premolar region, Prevents crowding in a well aligned lower arch, Aids distal movement of the buccal segments with extra oral traction, Shorter treatment time, Finctional occlusion is better.
The ideal time for extracting second molars is when the third molar crown is fully formed and other claim should be extracted as soon as they erupt into the mouth.Several consideration need to be taken before extracting second molar, include radiological evaluation of third molar, should be present, have good size, shape and position.

THE EXTRACTION OF PRIMARY TEETH AS PART OF ORTHODONTICS TREATMENT

Extraction of a primary tooth it is often a dilemma whether to merely remove the unsaveable tooth, to extract a contralateral tooth from the same arch (balance) designed to minimize centerline shift, or to extract a tooth from the opposing arch ( compensation) designed to minimize occlusal interferance by allowing teeth to maintain occlusal relationships as they drift.
Early loss of one primary canine cause centerline shift.The more crowded the dentition, the more the need for balance extraction. Centrelines shift with complete space closure, delay balancing extraction until a full orthodontics assessment is made. Loss of a primary second molar, especially the second may allow mesial drift of the first permanent molar.There is no need to balance extraction because this will have no appreciable effect in centerlines . However this extraction may allow forward movement and tilting of the adjacent first permanent molar .Therefore consideration should be given a space maintainer