damon-intheclinic-casestudies-extractioncases

Clinicians around the world using the Damon System mention that they are extracting far few cases. There seems to be a growing awareness of the positive impact that Damon treatment planning has on the maturing profile. Even though this technology broadens the horizons of Face Driven Orthodontics, it should be very clear that there is a time to extract. In a practice where the face drives the treatment plan, I extract in the following situations:

• In extreme midline discrepancies where there are no other treatment options.
• Setting up cases for surgery.
• To improve bone and tissue contours around extremely poorly positioned teeth without negatively impacting the patients facial profile.
• To meet anteroposterior occlusion requirement where other options have been eliminated.
• In severe bimaxillary protrusion cases where correcting severe crowding without extractions will have a negative effect on the profile.

In extraction cases, it is strongly recommended to retract the anterior teeth “en masse” (see en masse). My research suggests that taking cuspids back independently can have a negative long term impact on the bone surrounding the cuspid. After watching many periodontal surgeries on patients treated before this technology was available, it is apparent that it is important to move teeth in groups rather than isolating individual teeth. Perhaps it is a vascular issue. Further research needs to done in this area.

This technology has a very significant impact on treaatment planning very crowded bimaxillary protrusion cases. With the engagement of very light archwires in a passive self-ligating bracket, it is very exciting to watch the anterior crowded teeth unravel into the extraction sites with little or no negative impact on posterior anchorage.