Orthodontic Protrusion Correction in Your 30s: Correction of Crowding and Extraction Treatment Period of 1 Year 8 Months

Hello.

Today, I’ll introduce orthodontic treatment in your 30s.

I’ll show you how we treated a case with two congenitally missing teeth using orthodontic treatment without implants.

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When teeth are missing, it is easy to think that implants are necessary, but in fact, the spaces can be closed with orthodontic treatment alone.

Especially if there is protrusion or crowding, it is good to proceed with treatment as if the missing teeth had been extracted.

Today, I’ll talk about such a case.

This is a patient in their 30s who visited in October 2023 for orthodontic treatment.

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There is a gap between the lower front teeth, and the upper front teeth are crowded.

There is a rough band on the front teeth, which is enamel hypoplasia.

It is not a problem that affects tooth health, but food tends to collect in the concave areas.

More careful oral hygiene is needed.

The front teeth also protrude.

Two of the four lower front teeth are missing.

When teeth are absent from birth, it is called congenital agenesis.

The patient only wanted to correct the alignment and the gaps with orthodontics.

However, since the upper teeth also protruded, we planned treatment with extraction of two upper premolars.

Since two lower teeth were already missing, extracting two upper teeth for orthodontic treatment would help balance things out and also resolve the crowding and protrusion limited to the upper arch.

In this case, the lower canines are pulled into the missing incisor spaces to replace the front teeth, and the lower premolars are pulled into the canine positions to replace the canines.

This makes it possible to achieve an accurate Class I molar relationship as well.

They chose Clippy C orthodontics.

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This is what it looked like 10 months after treatment began.

The upper extraction spaces are visible.

On the lower arch, the canines are being pulled into the incisor positions.

Although the patient was in their 30s, tooth movement was relatively fast,

and treatment was completed in 1 year and 8 months from the start.

25.06

The midline is precisely aligned, and the front teeth bite is good.

The blue arrow actually points to a canine, not a front tooth.

The molar relationship is exactly Class I. The blue arrow in the canine position is actually the first premolar, not the canine.

Now let’s look at the before-and-after comparison. The total treatment period was 1 year and 8 months.

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It was neatly completed with orthodontics alone, without implants.

The bilateral molar relationship improved from the original Class III to Class I.

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The crowding and protrusion of the front teeth were resolved.

Now let’s look at the facial changes.

A cleaner smile

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Cleaner front-tooth angle

The upper protrusion was resolved.

25.06

There was no root resorption, and the root parallelism is good.

Whether the teeth are congenitally missing or were extracted later,

if there is an empty space because teeth are missing, I strongly recommend visiting a nearby orthodontic specialist first rather than considering implants first.

Once an implant has been placed, there are many cases where orthodontic treatment later becomes difficult.

I hope you have a good day today as well.