Three Different Phoenix Orthodontist Treatment Approaches

1. One Phoenix orthodontic option for Emily would be to extract e/5 and have the Phoenix dentist restore the 2/. This Phoenix orthodontic option would be chosen if Emily’s teeth were crowded and/or her facial profile would not be negatively impacted by extractions. In this situation, additional anchorage is needed for the left maxillary 1st molar until the Class II relationship is corrected. If the contralateral lateral incisor is the appropriate size it can be used a guide of how much space to leave around the peg lateral. A diagnostic wax up is often useful in cases requiring restorations of anterior teeth to determine ideal spacing. This Phoenix orthodontic treatment approach has the advantage of being cost effective since restorative issues surrounding the missing 5 have been eliminated.

2. A second Phoenix orthodontic option for Emily would be to extract e/5 and have the Phoenix dentist restore the 2/. This Phoenix orthodontic option would be chosen if Emily has significant maxillary protrusion or anterior crowding. This extraction pattern would also help with the Class II correction on the left side. Additional anchorage is still required for the left maxillary 1st molar until the Class II relationship is corrected. Once again appropriate spacing is needed for the restoration of the peg lateral. This approach is still cost effective since restorative issues surrounding the missing 5 are eliminated.

3. A third Phoenix orthodontic option is not to extract any teeth and have the Phoenix dentist restore the 2/. This option would be chosen if the patient’s facial profile could not tolerate the extraction of premolars. Class II correction could be achieved by a variety of means. Examples include: unilateral facebow, bulbous loops, pendulum, Wilson distalizing arch, Class II elastics, etc. Proper spacing is still required for the restoration of the lateral incisor. The lower e can be retained for future restorative considerations. Since the mesiodistal width of the e is larger than that of the 5 that replaces it, retaining the e causes some occlusal discrepancies in the premolar/molar region. Kokich recommends reducing the mesiodistal width of the e with a fissure bur to the size of a lower 5. The e can then be retained to maintain adequate space and alveolar bone height for future restoration. This Phoenix orthodontic treatment approach is not as cost effective but will likely lead to a nice result.