A Case of Bi-maxillary Protrusion Treated with Extraction of the First Premolars and Upper First Molars

Abstract

The patient was a female aged 18 years and 6 months. Her complaints were a convex profile and unesthetic appearance of her anterior teeth. She was diagnosed as having severe bi-maxillary protrusion with moderate upper and lower crowding. Treatment was carried out using edgewise orthodontic appliances with upper and lower first premolar and additional upper first molar extraction. Premolar extraction and molar distalization sometimes becomes necessary in bimaxillary protrusion with crowding cases because of the need to correct the crowding and the axial inclination of both anteriors.
In this case, the upper right first molar, for which an inappropriate root canal treatment had been conducted, and the upper left first molar were diagnosed as secondary caries. Therefore, the upper first molars were extracted, and the third molars were aligned to compensate for the first molars owing to consideration of a long-term prognosis, correction of the crowding, tooth axial, and achieving a straight profile without reinforced anchorage.