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Quintessence Publishing: Journals: ORTHODONTICS
ORTHODONTICS
The Art and Practice of Dentofacial Enhancement

Formerly World Journal of Orthodontics

Edited by
Rafi Romano, DMD, MSc (Editor-in-Chief)

ISSN 2160-2999 (print) / ISSN 2160-3006 (online)

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Publication:
Fall 2002
Volume 3 , Issue 3

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Making the Premolar Extraction Smile Full and Radiant

Pedro Leitao


There is a current trend in our specialty to avoid extractions of teeth. Some selfappointed “experts” send invitations to orthodontists promoting courses in which it is claimed that using their technique and philosophy, almost 99% of malocclusions can be corrected without sacrificing teeth to create beautiful, “radiating” smiles. These treatment results are also claimed to enhance orthodontic stability, although there is apparently little proof to back up the statement. It is claimed that extracting teeth to resolve crowding will, in most cases, produce a narrowing of the smile and/or irreversible areas of darkness at the corners of the mouth. While preserving the dentition is a worthwhile goal whenever possible, there are, in my opinion, obvious situations when tooth size–jaw size discrepancies, as well as other reasons, call for premolar extractions. Does this imply that the smiles in patients who have received orthodontic treatment involving premolar extractions will become different from those in the nonextraction patients? In other words, are premolar-extraction smiles generally more constricted and less attractive than the nonextraction smiles?

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