A extração de segundos molares superiores para o tratamento da Classe II

Abstract

The purpose of this article is to present an alternative approach to the orthodontic treatment of Angle Class II malocclusion. According to a literature review it was observed that the extraction of upper second molars has proven to be a viable alternative for the treatment of this type of malocclusion. This therapeutic option enables faster first molar retraction and requires less patient compliance. However, the level of development, intraosseous position and morphology of the third molar should be carefully evaluated to ensure its correct positioning in place of the extracted second molar. Two clinical case reports will demonstrate that the sequence of diagnosis and treatment used with this mechanics yields satisfactory functional and aesthetic results. Abstract

Extrações de molares na Ortodontia

“…In cases where third molars erupt out of position and prevent the achievement of an adequate functional occlusion, orthodontic retreatment is indicated to position them correctly. 21 In terms of relapses in the anteroposterior direction, cases treated with extraction of second molars seem to be quite stable. 21…”

“…21 In terms of relapses in the anteroposterior direction, cases treated with extraction of second molars seem to be quite stable. 21…”

“…17,19 Second molar extraction is a viable alternative to be considered when these teeth are severely damaged or poorly positioned and when there is crowding in the posterior region, although it should not be considered as an alternative to replace premolar extraction in cases of dental crowding in the anterior region, or even in severe incisor protrusion cases. 17, 20,21 It is also indicated in cases of third molar impaction, despite the uncertainty involving its eruption in an acceptable position, and prevention of late crowding in the lower arch. 17,18,20,21 One factor should be taken into account before recommending the extraction of second molars, i.e., verifying the presence of third molars, making sure they are well positioned and have an adequate coronary and root anatomy.…”

“…17, 20,21 It is also indicated in cases of third molar impaction, despite the uncertainty involving its eruption in an acceptable position, and prevention of late crowding in the lower arch. 17,18,20,21 One factor should be taken into account before recommending the extraction of second molars, i.e., verifying the presence of third molars, making sure they are well positioned and have an adequate coronary and root anatomy. 17 The ideal time to recommend second molar extraction is when the third molars have begun root development, but it is not always possible to start orthodontic treatment in this phase, which does not preclude treatment in adults whose third molars have erupted.…”

“…17 The ideal time to recommend second molar extraction is when the third molars have begun root development, but it is not always possible to start orthodontic treatment in this phase, which does not preclude treatment in adults whose third molars have erupted. 21 When treatment is started at the ideal stage it is usually completed before the eruption of third molars, causing, in some cases, extrusion of the opposing teeth (antagonists). Orthodontists must exercise caution and place an appropriate retainer.…”