Serial extractions as treatment for several tooth-arch discrepancy: case report

Abstract

Introduction: Negative discrepancy occurs when the dental volume is greater than the available space. For the treatment of severe negative discrepancies, the implementation of dental material reduction through serial extractions has been described, which is the planned and sequential extraction of primary and permanent teeth, to favor correct alignment and decrease the complexity of corrective orthodontic treatment. Case report: This is a 5-year-old female patient with Class I malocclusion type 1, 3, and 4 of Angle modified by Anderson and mouth breathing. Expansion with Hyrax was performed. At the clinical and radiographic reevaluation at 9 years of age, a severe negative discrepancy with ectopic lower canines and Dens in dente in tooth 22 was evident. Radiographically, tooth 23 is presented with mesial inclination in close relation to the root of tooth 22. Cone beam tomography was performed to demonstrate root integrity. Serial extractions of primary teeth and enucleation of first premolars were performed, along with a maxillary expander to correct the negative discrepancy and dental malpositions. Conclusions: Serial extractions improve therapeutics in well-planned patient cases and are of great importance for reducing the use of complex mechanics and prolonged treatments.