Interproximal reduction in lieu of extractions

[kjohnt]

Has anybody here had this done?  Basically shaving the sides of the tooth enamel down to thin the teeth to make them fit together properly within the arch.

How much enamel can be taken from a single tooth?

Regarding pre-surgical orthodontics and decompensation, I always read about premolar extractions, and know one person on here who had one lower incisor extracted, but I don't hear about this much.

[ditterbo]

My ortho from many years ago shaved down my teeth just to fit my current arch.  I think the issue with shaving is your teeth will start to look like thin little stalks if it's overdone.  Dr. Posnick had said he would want my lower bicuspids extracted for maximum BSSO movement. 

[PloskoPlus]

Sounds like a bad idea.

[Lazlo]

Terrible idea, final word. Yes I know what I'm talking about it was offered to me. As are extractions.

[kjohnt]

My ortho from many years ago shaved down my teeth just to fit my current arch.  I think the issue with shaving is your teeth will start to look like thin little stalks if it's overdone.  Dr. Posnick had said he would want my lower bicuspids extracted for maximum BSSO movement.

That's unfortunate you did that and will have to have extractions anyway.

Sounds like a bad idea.

My gut tells me you're correct. 

Terrible idea, final word. Yes I know what I'm talking about it was offered to me. As are extractions.

But at some point something must be done to decompensate if the teeth don't fit within the arches.  It's either extractions, tooth reduction, or proclined incisors masking a class II or class III...

[Lazlo]

Okay I see the issue. It's true for maximum cosmetic and functional effect the lower bicuspids only will be extracted. Actually there are ways to make the arches bigger, SARPE or rapid palatal expansion is a method. But that means a surgery to install the gear, keeping it in your mouth for several months which is not terribly comfortable and then moving the teeth back in place which is fast. I don't know why docs don't prescribe this regularly for small arches. THE ARCHES CAN BE GROWN TO accomadate the TEETH INSTEAD OF THE OTHER WAY AROUND. Maybe they think of it as too much work. I dunno frankly since i've never gotten a straight answer on this. I know that if you make the upper jaw bigger where you probably have a bit of crowding too, then the lower jaw will fit and can be decomposated. But honestly if that's all he's gonna do is take out two lower bicuspids he's going to then maximize the discrepancy so there can be a large movement when he does surgery. If Posnick is overseeing this and says it's the right move then I would do it. Since it's not a f**king moron orthodontist who is calling the shots here I would go with what Posnick requests since he'll be able to do a larger movement. It's the right move and I'd be relatively comfortable with following this.

[ditterbo]

Okay I see the issue. It's true for maximum cosmetic and functional effect the lower bicuspids only will be extracted. Actually there are ways to make the arches bigger, SARPE or rapid palatal expansion is a method. But that means a surgery to install the gear, keeping it in your mouth for several months which is not terribly comfortable and then moving the teeth back in place which is fast. I don't know why docs don't prescribe this regularly for small arches. THE ARCHES CAN BE GROWN TO accomadate the TEETH INSTEAD OF THE OTHER WAY AROUND. Maybe they think of it as too much work. I dunno frankly since i've never gotten a straight answer on this. I know that if you make the upper jaw bigger where you probably have a bit of crowding too, then the lower jaw will fit and can be decomposated. But honestly if that's all he's gonna do is take out two lower bicuspids he's going to then maximize the discrepancy so there can be a large movement when he does surgery. If Posnick is overseeing this and says it's the right move then I would do it. Since it's not a f**king moron orthodontist who is calling the shots here I would go with what Posnick requests since he'll be able to do a larger movement. It's the right move and I'd be relatively comfortable with following this.

SARPE isn't for the lower arch,  I thought?  That's an option for the OP perhaps if he has crowding along the maxilla.  A cursory google search suggests there is no way to widen the jaw bone, so no way to decompensate the lower arch w/o extractions if the teeth are already canted.