Goodyear Orthodontic Treatment Options

Option 1:
If there is significant crowding in each arch, a good Goodyear orthodontic treatment option may be to extract the peg lateral, the lower left 5, and the lower right E. Extraction of the peg lateral would allow Goodyear orthodontists to do canine substitution in the maxillary arch. This would address the crowding, the missing tooth, and the peg lateral. The extraction of the lower left 5 and lower right E would address the crowding issue as well as the missing tooth on the other side. The biggest advantage of this Goodyear orthodontic treatment option is the minimal costs for restorative treatment. The maxillary canines and first premolars may need some re-contouring, but no expensive restorative treatment is necessary.

Option 2:
If there were minimal crowding in the maxillary arch, the Goodyear orthodontist would lean towards restoring the peg lateral and opening space for the contralateral tooth. Assuming the midlines are coincident and the upper left 6 drifted mesially to create the Class II relationship, the Goodyear orthodontist would use a Pendex appliance to move the molar distally and open space. The long-term restoration of choice for the missing lateral incisor would be an implant, however, since she is still growing the Goodyear orthodontist would probably use a Hawley with a pontic tooth as the short-term restorative option.

With minimal mandibular crowding, the Goodyear orthodontist’s treatment of choice once again would be an implant. In order to maintain bone height and width, the Goodyear orthodontist would maintain the primary tooth until the implant is going to be placed. The Goodyear orthodontist would have the implant placed in the ideal position for restoring a normal sized second premolar (look at contralateral tooth). Once the implant and a temporary crown are placed, the Goodyear orthodontist would bond the lower right 5, 6, and 7. Then the Goodyear orthodontist would move the molars forward to close the leeway space from the large E.

Option 3:
The final treatment option would be the same for the maxilla. In the mandible, however, I would place a miniscrew distal to the lower right 3 roots. The Goodyear orthodontist would extract the lower right E and use the miniscrew as anchorage to protract the mandibular molars to close the space. This would result in a Class III molar relationship on that side, but obviate the need for a restoration in that quadrant.

The Goodyear orthodontist would sit down with Marcy and her family and explain the situation (peg lateral, missing teeth, molar relationship). The Goodyear orthodontist would then discuss some of the options for addressing these problems (canine substitution, implants, resin bonded bridges) along with the advantages and disadvantages of each option. Next, the Goodyear orthodontist would discuss Marcy’s age and that if an implant is the ultimate restorative plan, her restorative treatment will not be complete until she has stopped growing. The Goodyear orthodontist would recommend that they also sit down and talk with their restorative dentist about different restorative options, as he/she will play a significant role in the overall treatment result. In addition, the restorative dentist can better estimate the cost of the restorative options. The Goodyear orthodontist would tell the patient that the Goodyear orthodontist is going to call their Goodyear dentist to discuss her situation and have him/her evaluate the restorative prognosis of the peg lateral.