Second premolar extraction procedures

Abstract

Dental alignment is only one of the objectives of orthodontic treatment. Other equally important objectives are the stability of dentition, health of the tissues, and the harmony and balance of facial aesthetics. The most important question that the clinician has to ask is whether the extraction of four teeth is warranted in borderline cases. Even if the extraction of four first premolars is a universally accepted procedure in borderline cases with light crowding, but without significant skeletal disharmony, it is best to wait for the permanent teeth to erupt and the profile to mature before decisions to extract and which teeth to extract are made. When the profile is harmonious or somewhat flat, in order to resolve the crowding problem, extraction of the second premolars can help because the anterior region can be controlled excellently. A treatment plan with these teeth extracted keeps the facial aesthetics unaffected.