Premolar enucleation. 1976

A H Ingram

A study was made on 27 cases where enucleation of four first premolars was performed simultaneously without introduction of mechanical devices to influence space closure. The results suggested that: 1. Enucleation of premolars can be used to minimize the severity of crowding in arch-length deficiency cases. 2. There is no damage to the remaining teeth and alveolar process when enucleation is accomplished with good surgical technique. 3. The average amount of lingual tipping of the mandibular incisors in approximately four years subsequent to the enucleation procedure was 4.1 degrees. 4. This amount of lingual tipping compares quite favorably with the amount of lower incisor uprighting experienced during growth and could not be considered excessive. 5. The mandible does tend to rotate in a counterclockwise manner following enucleation of four first premolars without appliance therapy. This rotation was considered significant in comparison with the amount of rotation that could be expected from an untreated sample. 6. If orthodontic treatment is planned, the enucleation of the manddibular second premolars in borderline extraction cases to avoid excessive lingual tipping of the mandibular incisors would seem to be questionable. 7. Various combinations of enucleation and tooth extraction may be helpful in treatment planning. 8. With judicious timing the enucleation of four first premolars can minimize the severity of the malocclusion simplifying appliance therapy if proper diagnosis and good surgical technique are employed. 9. Although conventional serial extraction may accomplish similar ends, it would appear that enucleation would offer some advantages in terms of autonomous adjustment of the mandibular incisors and root positioning of mandibular cuspids. 10. Enucleation cases usually require fewer traumatic surgical procedures and less supervision by the orthodontist. 11. The parents should be informed that serial extraction procedures including enucleation may simplify but will not eliminate the need for appliance therapy.

UI MeSH Term Description Entries
D007180 Incisor Any of the eight frontal teeth (four maxillary and four mandibular) having a sharp incisal edge for cutting food and a single root, which occurs in man both as a deciduous and a permanent tooth. (Jablonski, Dictionary of Dentistry, 1992, p820) Incisors
D008297 Male Males
D008310 Malocclusion Such malposition and contact of the maxillary and mandibular teeth as to interfere with the highest efficiency during the excursive movements of the jaw that are essential for mastication. (Jablonski, Illustrated Dictionary of Dentistry, 1982) Angle's Classification,Crossbite,Tooth Crowding,Cross Bite,Angle Classification,Angles Classification,Bite, Cross,Bites, Cross,Classification, Angle's,Cross Bites,Crossbites,Crowding, Tooth,Crowdings, Tooth,Malocclusions
D008334 Mandible The largest and strongest bone of the FACE constituting the lower jaw. It supports the lower teeth. Mylohyoid Groove,Mylohyoid Ridge,Groove, Mylohyoid,Grooves, Mylohyoid,Mandibles,Mylohyoid Grooves,Mylohyoid Ridges,Ridge, Mylohyoid,Ridges, Mylohyoid
D001862 Bone Resorption Bone loss due to osteoclastic activity. Bone Loss, Osteoclastic,Osteoclastic Bone Loss,Bone Losses, Osteoclastic,Bone Resorptions,Loss, Osteoclastic Bone,Losses, Osteoclastic Bone,Osteoclastic Bone Losses,Resorption, Bone,Resorptions, Bone
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003724 Dental Arch The curve formed by the row of TEETH in their normal position in the JAW. The inferior dental arch is formed by the mandibular teeth, and the superior dental arch by the maxillary teeth. Arch, Dental,Arches, Dental,Dental Arches
D005145 Face The anterior portion of the head that includes the skin, muscles, and structures of the forehead, eyes, nose, mouth, cheeks, and jaw. Faces
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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