Extraction Orthodontics for Crowded Teeth and Protrusive Mouth: Only 2 Upper Teeth Removed, Upper-Jaw-Only Extractions with Clippy C, Treatment for Lip Incompetence

Hello.

This is Apgujeong Orthodontic Dental Clinic.

2023.02~2025.05

If crowding and protrusion are both present, extraction orthodontic treatment is needed.

When protrusion and crowding are limited to the upper teeth, only the two upper premolars may be extracted.

The things patients worry about most before extraction orthodontic treatment are unwanted side effects on the facial profile, such as a flat mouth, buck teeth, thinner lips, or a longer philtrum.

A treatment process that takes these factors into account is important.

23.02

This is a middle school patient who came in for orthodontic treatment in February 2023.

Crowding, a midline discrepancy, and deep overbite are noticeable.

When there is crowding, the dental midline shifts toward the side with the crowding.

Through orthodontic treatment, the dental midline needs to be aligned with the nose and philtrum.

There is also flaring of the front teeth, so there is a slight protrusive mouth profile.

To resolve the crowding and protrusion, premolar extraction orthodontics was needed.

However, a plan was made to extract only 2 teeth in the upper jaw.

If a total of 4 premolars, including the lower premolars, were removed, the mouth would retract too much.

Clippy C braces were chosen, and treatment began.

This is what it looked like one year after starting treatment.

24.02

About one-third of the extraction space in the upper jaw remained on one side, and the second molar on that side had not yet erupted.

While waiting for the second molars to erupt, treatment continued slowly.

At the end of orthodontic treatment, a removable retainer needs to be made,

and it is best to make it after the second molars have erupted.

So it is better to postpone the end of treatment until after the second molars come in.

At 2 years and 3 months after starting treatment, the treatment is finally completed.

25.05

The midline is well aligned, and the bite is clean.

Many people ask, "Is the bite okay if only the upper premolars are extracted?"

This is the bite after extraction orthodontic treatment with upper-jaw-only extractions.

Now let's look at the before-and-after comparison.

23.02~25.05

The total treatment period was 2 years and 3 months.

23.02~25.05

23.02~25.05

Now let's look at the facial profile comparison.

23.02~25.05

The upper dental midline is aligned with the nose and philtrum.

The 2 mm discrepancy has been corrected, aligning the upper and lower dental midlines.

The dental arch has become more compact with an appropriate oral corridor.

A gentle U-shaped smile line.

The smile looks much more organized and clean.

23.02~25.05

The front teeth have neither flared too much nor retracted too far like buck teeth; the angle is appropriate.

23.02~25.05

The lip protrusion also improved without being excessive, while maintaining lip volume.

As shown in the results, extracting 4 premolars was unnecessary.

As the upper tooth protrusion was resolved, the lips close comfortably.

At the time of treatment, the patient was still in middle school, so the lower jaw grew a little due to growth.

I hope this post is helpful for those who need orthodontic treatment for crowding and protrusive mouth.