How bad is premolar extraction

[AlwaysHaveQuestions]

If doing it mainly for aesthetic. Why do people advise so much against extraction? It doesnt seem that bad imp

 

[everythingisacope]

it narrows your palate but you might get more symmetry

 

[Babushkacatlady]

What is your malocclusion?

 

[AlwaysHaveQuestions]

What is your malocclusion?

its good
i want it to reduce philtrum protrusion

 

[Babushkacatlady]

its good
i want it to reduce philtrum protrusion

I advise against it in all cases UNLESS you are and adult with bimaxillary protrusion (really bi dental), who would like to get non surgical and more instantaneous results (if you don't mind the long term health risk) OR it is part of orthognathic surgery prep. Regardless, you're gonna mess up your tongue space and airway health for a long time and you will increase your chance of bruxism, TMJ, and obstructive sleep apnea.

 

[Gaia262]

If doing it mainly for aesthetic. Why do people advise so much against extraction? It doesnt seem that bad imp

I had my lower Premolars removed as part of my trimax/jaw surgery procedure.

It definately did change my face for the worse. But this is temporary, untill my jaw surgery. (It gets worse before it gets better)

Never extract teeth unless its for jaw surgery even then IMDO is superior as no extractions at all have to happen.

 

[tyronelite]

 

[Babushkacatlady]

The thing with bimaxillary protrusion is that the teeth are supposed to be upright (proper lip seal) and if anything the upper incisors are too far back and just tilted, they should instead be more forward and up and upright. It is just an illusion of protrusion due to the interincisal angle. But premolar extractions can give immediate aesthetic results but for the optimal one should just make sure not to have the tongue tip between the teeth, and have a good lip seal.

 

[tyronelite]

The thing with bimaxillary protrusion is that the teeth are supposed to be upright (proper lip seal) and if anything the upper incisors are too far back and just tilted, they should instead be more forward and up and upright. It is just an illusion of protrusion due to the interincisal angle. But premolar extractions can give immediate aesthetic results but for the optimal one should just make sure not to have the tongue tip between the teeth, and have a good lip seal.

Can I pm you with pics? Maybe you could figure out my issue lol

 

[Babushkacatlady]

Can I pm you with pics? Maybe you could figure out my issue lol

Sure

 

[AlwaysHaveQuestions]

The thing with bimaxillary protrusion is that the teeth are supposed to be upright (proper lip seal) and if anything the upper incisors are too far back and just tilted, they should instead be more forward and up and upright. It is just an illusion of protrusion due to the interincisal angle. But premolar extractions can give immediate aesthetic results but for the optimal one should just make sure not to have the tongue tip between the teeth, and have a good lip seal.

are you saying its the alveolar thats too forward and the incisor is actually leaning back?

what is the solution? im not sure i follow what you mean by tongue not between the teeth.
i read on another forum it said to make the tongue not push on the incisors. are you referring to that?

 

[Babushkacatlady]

are you saying its the alveolar thats too forward and the incisor is actually leaning back?

what is the solution? im not sure i follow what you mean by tongue not between the teeth.
i read on another forum it said to make the tongue not push on the incisors. are you referring to that?

Black shows position of incisors in bimaxillary protrusion and green shows their optimal position and red shows them after premolar extraction and retraction. Note how the incisors are actually further forward and up but upright in the optimal position, this shows how bimaxillary protrusion is no more than an illusion. See how the premolar extraction causes a little clockwise rotation of the mandible due to the incisors trapping the mandible further back.

On a face it'd look like this:

(Bimaxillary protrusion)

(Premolar extraction)

(Optimal position)

 

[Babushkacatlady]

Actually I found a pic of the actual case go this kid, his face changed from premolar extraction exactly as I predicted, go figure:

From this

to this

 

[oldcell]

I have molars extracted and it gave em slight recession of lower third over years, but hollower cheeks

Thats why i have a beard to fraud

For some people, extraction can make u better looking, for some u end up looking slight worse but changes are very subtle

 

[AlwaysHaveQuestions]

Black shows position of incisors in bimaxillary protrusion and green shows their optimal position and red shows them after premolar extraction and retraction. Note how the incisors are actually further forward and up but upright in the optimal position, this shows how bimaxillary protrusion is no more than an illusion. See how the premolar extraction causes a little clockwise rotation of the mandible due to the incisors trapping the mandible further back.
View attachment 1039037
On a face it'd look like this:

(Bimaxillary protrusion)

View attachment 1039045

(Premolar extraction)
View attachment 1039057

(Optimal position)

View attachment 1039067

yes but idt green can be achieved.
lefort 1 could work but you still have to do extraction for the teeth space-> lefort 1 cw

 

[Babushkacatlady]

yes but idt green can be achieved.
lefort 1 could work but you still have to do extraction for the teeth space-> lefort 1 cw

Your teeth will at least upright in their position now provided you keep your teeth together, tongue on the palate instead of between teeth and lip seal intact. Most people with bimaxillary protrusion tend to not do this. Green can be achieved over a much longer time window with good oral posture, it all depends on how far your incisors are relative to their optimal position and how long you do it.

 

[SOS-Sonic]

Your teeth will at least upright in their position now provided you keep your teeth together, tongue on the palate instead of between teeth and lip seal intact. Most people with bimaxillary protrusion tend to not do this. Green can be achieved over a much longer time window with good oral posture, it all depends on how far your incisors are relative to their optimal position and how long you do it.

I can see how mewing and keeping teeth together helps, but I don't see a correlation between lip seal and facial growth, can you please elaborate on that?

 

[Babushkacatlady]

I can see how mewing and keeping teeth together helps, but I don't see a correlation between lip seal and facial growth, can you please elaborate on that?

Lip seal uprights the incisors during growth and essentially guarantees that you don't mouth breathe (since the lips are closed)

 

[SOS-Sonic]

Lip seal uprights the incisors during growth and essentially guarantees that you don't mouth breathe (since the lips are closed)

I see, so it just prevents front teeth from flaring out too much right?

 

[weallburninhell]

Black shows position of incisors in bimaxillary protrusion and green shows their optimal position and red shows them after premolar extraction and retraction. Note how the incisors are actually further forward and up but upright in the optimal position, this shows how bimaxillary protrusion is no more than an illusion. See how the premolar extraction causes a little clockwise rotation of the mandible due to the incisors trapping the mandible further back.
View attachment 1039037
On a face it'd look like this:

(Bimaxillary protrusion)

View attachment 1039045

(Premolar extraction)
View attachment 1039057

(Optimal position)

View attachment 1039067

dude had flat chin for the first place, maxilla dont cause that its just hes genetics thats why its look more flatter after extraction because its already flat

 

[faggotchadlite]

I have molars extracted and it gave em slight recession of lower third over years, but hollower cheeks

Thats why i have a beard to fraud

For some people, extraction can make u better looking, for some u end up looking slight worse but changes are very subtle

does it affect face that much , specially if the extraction is in upper jaw