Any prons & cons ? Long-term outcomes and clinical observations ? How about the chances of proper eruption of third molars ? What is the acceptable clinical justification for these extractions ? Orthodontist opinion from their area of expertise would be highly appreciated.
Extraction of second molars as an orthodontic measure is a simple procedure which can lead to good clinical results. Indications as well as timing and long term effects on buccal occlusion have been discussed. It has been concluded that acceptable results may only be expected when the extraction is strictly indicated and carried out in cases when the third molars have reached their full crown stage but before radiographic evidence of root formation. Upper third molars with an angulation of less than 30 degrees and lower third molars with an angulation of 30-60 degrees to the occlusal plane are likely to give a satisfactory position after eruption.
best wishes
Ulrich
As Cavanaugh (1) has pointed out, third molars, both upper and lower, do usually erupt into the place of electively removed second molars. None of the third molars in this study group became impacted during the observation period. Second molars in this study were removed before the roots had formed on the third molars. The bifurcation line appears to be a stable reference on the panoramic radiograph.
1) Cavanaugh JJ. Third molar changes following second molar extractions. Angle Orthod. 1985 Jan;55(1):70-6.
Thank you for prompt and valuable comments. Your opinions are highly appeciated.
Extraction of second molars in preference to first permanent molar is a procedure that has been advocated and carried out since the 1960's. There were a number of publications on that subject at that time. A current article on this subject is written by Hans Booij; Orthodontic Pearls Second edition,CRC Press 2015. Chapter 24 page 165.
If indicated, extraction of second molars can be performed. However, it depends on the type of case. If first molar is restored or having a poor prognosis, then it should be extracted. Both first and second molar extraction is relatively less common in orthodontics as compared to premolars.
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