Missing 2nd premolar with space closure

Pre Treatment

Progress

The 75 & 85 were removed to allow the remaining lower teeth to drift and undertake some of the space closure naturally prior to placing braces. A new OPG x-ray was taken and confirms that the upper wisdom teeth are not forming.

Braces are then placed initially on the lower teeth as there is more work to be undertaken on the lower teeth when compared to the upper teeth.

Temporary Anchorage Devices (TAD’s) are then used in the lower to help with moving the lower posterior teeth forwards increasing the space for the wisdom teeth and keeping the front teeth as far forward as possible to maintain the profile and fullness of the lips.

Upper braces are then placed to complete treatment.

Final

Treatment completed and the patient is wearing an upper clear plastic removable retainer at night and a lower fixed lingual wire retainer. These photos are 4 years after the completion of orthodontic treatment. The OPG x-ray shows that the lower wisdom teeth are in reasonable positions to erupt by themselves. The root structure of the upper baby second molar teeth is reasonable and so these teeth should survive for many years (some patients in to their 50’s).

With this method of treatment the patient ends up with a very attractive dental appearance and has the same number of teeth in the upper and lower jaws creating balance and symmetry. If and when the upper baby second molars fail they can be replaced with false teeth as needed.