premolars extractions

[Balanced]

Btw about 10 years ago i was advised to have my lower premolars extracted. They were out of the arch. I am glad i resisted but alas I didnt get all of the issues resolved at the time either. I know a little more now.

Thanks yxcvb for the video.

[indigochild]

This is an interesting blog. This person is currently undergoing extraction reversal and so far so good...

http://claimingpower.com/reverse-extraction-orthodontics-is-it-possible-for-adults-progress-report/

[buzzhead]

Not really sure where to jump into the forum so I guess I will start here.  I am a 55 year young male in braces preparing for bi max surgery to correct a deep overbite and sleep apnea.  I suffer from short face syndrome and underwent orthodontic treatment when in my late teens. 

At the time my Ortho decided that I needed four first pre molars removed.  Two upper, two lower.  When I looked at my face at the time, I remember thinking that my upper face looked fine, just my lower jaw was too small.  Although I had reservations about taking our four perfectly good teeth, I was young and too trusting of their "expertise".  As treatment went along I became concerned as my face receded backwards and my upper teeth seemed to disappear behind my upper lip.  I remember complaining to the Otho about my concern and he would get irritated and tell me that it wasn't that much and things would turn out fine.  Well they didn't, in my opinion.

I did not like my smile or my profile.  I spent the next several decades disliking and being self conscious about my appearance.  Much too long to do that.  On top of that, my deep bite, that never really was corrected anyway, relapsed and I developed sleep apnea as well.  I needed, REQUIRED, surgical treatment back then.

Upon the recommendation of my new, young, dentist, I was referred to an orthodontist who worked as a team with a jaw surgeon at a University hospital.  Too make a long story a little bit shorter, I found out what my problems were and what would be needed to make corrections.

At first I was angry with my first Ortho but after researching this subject, this forum a big part of that, I have come to the conclusion that back then jaw surgery was not nearly as advanced as it is today and he did what was the norm at that time.

As I said,  I have short face syndrome with retronathic upper and lower jaws.  My treatment consist of decompensating both arches followed by bi max surgery to bring both jaws forward, down grafting the maxilla with clockwise rotation of both jaws.  I have been back in braces for 18 months and hope to be forwarded to the surgeon soon.

[Langpam]

I am a little older than you and had bimaxillary plus genioplasty in November. Before the operation I had 67.5 apnoeas an hour but I have not used my CPAP since the op. Results of my sleep study stated that I now had ZERO apnoeas an hour. The aesthetic benefits are worth it too.
You will really notice the difference. Best of luck.
( check out my before and after pictures in the section on Overbites)

[Alue]

Not really sure where to jump into the forum so I guess I will start here.  I am a 55 year young male in braces preparing for bi max surgery to correct a deep overbite and sleep apnea.  I suffer from short face syndrome and underwent orthodontic treatment when in my late teens. 

At the time my Ortho decided that I needed four first pre molars removed.  Two upper, two lower.  When I looked at my face at the time, I remember thinking that my upper face looked fine, just my lower jaw was too small.  Although I had reservations about taking our four perfectly good teeth, I was young and too trusting of their "expertise".  As treatment went along I became concerned as my face receded backwards and my upper teeth seemed to disappear behind my upper lip.  I remember complaining to the Otho about my concern and he would get irritated and tell me that it wasn't that much and things would turn out fine.  Well they didn't, in my opinion.

Man that sounds pretty much like my story.  Only that was a little over a decade ago for me.  Orthodontist are still doing the same s**t today, although not all are. 

[Lazlo]

What can you do to go back to normal after having Pre-molars out?

You can't. You're f**ked. If you try and open up the spaces and put in implants it'll destroy the roots of your other teeth. You can wait till 2040 when by sure they'll have a way to generate and grow real teeth from stem cells and then you can have all your teeth replaced, but you'll still have to have distraction osteogenesis to grow back your jawbone.

When they take out teeth the jaw bone in that area actually shrinks too, so it does the opposite of jaw surgery and shrinks for most of us our already defecient jawbones. I didn't know any of this when I let that motherf**ker of an orthodontist send me to have my teeth pulled.

[Langpam]

Lazio, you have an anger issue.

[yxcvb]

Whats the effect of extracting wisdom teeth on the jawbone? Does it cause bone loss? I'm talking about in an adult case when jaw development is finished.

[Alue]

Lazio, you have an anger issue.

To be fair, I get angry every time I think about what my orthodontist did to me when I was a kid. 

Anger is one of the many complications of premolar extractions. 

[Langpam]

I think that on an open forum it's worth expressing views in an appropriate manner. Nothing can be gained by venting one's rage.
I think we all feel angry at times, but it is preferable to exercise control, especially with one's choice of language. Also, some of the content of this person's other posts leaves a lot to be desired.

[notrain]

At first I was angry with my first Ortho but after researching this subject, this forum a big part of that, I have come to the conclusion that back then jaw surgery was not nearly as advanced as it is today and he did what was the norm at that time.

A short history of jaw surgery to soothe all the angry people:

late 1960s: obwegeser pioneered lower jaw surgery which then became widely used (BSSO).

late 1970s: the current LeFort 1 Osteotomy gets pioneered in the U.S.

Between 1968 and ca. 1980, only the lower jaw was operated on regardless if the patient needed advancement of the upper jaw as there was no osteotomy to advance the entire upper jaw in one piece. Bimaxillary jaw surgery was impossible.

Also, orthognathic surgery and orthodontics were not used like today where the orthodontist DECOMPENSATES the skeletal anomaly prior to surgery. Rather, a patient would be treated orthodontically COMPENSATING for his skeletal malocclusion as much as possible and then he would get referred to the surgeon to make up the last bit the orthodontist was unable to move the teeth.

Unsurprisingly, with this treatment approach and without modern imaging technology, jaw surgery results back then were utter s**t aesthetically speaking, especially during the time where only single jaw surgery was possible.

The shift to the current approach - ortho decompensates and surgeon harmonizes the skeleton fully - is actually pretty recent (~20 years) and it took quite some time to become standard level of care.

The strong focus on improving facial aesthetics along with the occlusion is even more recent. So it's not like an ortho treating a patient 10,15,20 years ago with compensation orthodontics was doing the patient a disservice necessarily. It should also be noted that decompensation orthodontics are an entirely different animal. To get a good surgery result, your orthodontist has to be top tier as well as the surgeon because decompensation orthodontics tooth movements are done abstractly while naturally occuring compensation forces are still present in the patient pre op. To decompensate a patient in all three dimensions fully is an art in itself.

[PloskoPlus]

A good ortho is super important.  But I still think that it's important to find the right surgeon first - he will have a good ortho that he works with.

[terry947]

So I saw a top orthodontist this week and he mentioned that I'd have to get my pre-molars removed to fix my bimaxillary protrusion. I'm wondering if this is something I should consider or just get jaw surgery with my bimaxillary protrusion? Is that any way to fix it without removing teeth?

[molestrip]

Why are pre-molars specifically significant? People remove wisdom teeth all the time. And what about the suggestion that I remove bicuspids? I don't see why either would impact TMJs necessarily as long as you get good occlusion and a functional jaw relationship. As to bone loss, that's natural with aging anyway but there's plenty of ways to augment bone these days.

[Lazlo]

Idiot, premolars ARE bicuspids. And quite trolling this topic moron. I've explained a million times why you shouldn't. GO AHEAD AND f**kING DO IT AND WEEP.