Orthodontists are often confronted with adult patients who have edentulous spaces in the molar areas or need extraction of molars with periodontal disease, extensive caries, large restorations, canal fillings, or apical pathologies. The patients who might benefit from this unusual molar extraction can be treated instead with the extraction of healthy premolars because of the doubtful long-term prognosis of their molars.
Unusual molar extraction space can be closed with various mechanics. However, decisions on whether to proceed with orthodontic tooth movement through some obstacles such as an atrophic ridge, gingival invagination, and pneumatized maxillary sinus must be made on a case-by-case basis based on criteria for success. The most important thing that we should consider in the unusual molar extraction treatment, the benefits of treatment should outweigh the potential risks.
Learning Objectives:
After this session, attendees will be able to:
Define and identify the various factors to determine whether to close or open the missing or extracted molar spaces.
Describe and explain the various clinical considerations when opening or closing molar spaces caused by missing or extracted molars.
Understand the proper biomechanics for opening or closing molar spaces without side effects.
