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Non-extraction Orthodontic Therapy Part 2
M. ABOULNASER- Orthodontist, BAU, USA.O. SANDID- Orthodontist, D.C.D., D.U.O, C.E.S.B.B, C.E.S.O.D.F ,
S.Q.O.D.F, Ex chargé de cours, Paris. France.
Contact: dr.aboualnaser@hotmail.com
Time 30 minutes
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Non-extraction Orthodontic therapy
• 1-Transverse Control, Expansion• 2-Sagittal Control, Reduction of overjet.• 3- Levelling of the curve of Spee on the proclination of
mandibular incisors and expansion of dental arches• 4-Molar distalization• 5-Stripping: Reduction of proximal enamel.• 6-Vertical Control: Unblocking of mandibular growth.
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Non-extraction Orthodontic therapy Transverse Control
Expansion-
Dr. Greenfeld orthofree.com
Gingival recession-Stabilty ?
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Non-extraction Orthodontic therapy Transverse Control
Expansion
Quadhelix Rapid Palatal Expander (RPE) Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
2-Sagittal Control- Overjet reductionFunctional appliance
2-Sagittal Control- Overjet reductionFunctional appliance
Early treatment , Bone Growth Stimulation, stop growingBenefits of early treatment stimulate mandibular growth and blockageof maxilla, reduce
overjet and treatment without extraction.
O.SANDIDNon-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
2-Sagittal Control- Overjet reductionIntermaxillary Class II elastics
2-Sagittal Control- Overjet reductionIntermaxillary Class II elastics
Frankel functional regulator
O.SANDID
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
2-Sagittal Control- Overjet reductionIntermaxillary Class II elastics- Cooperation
2-Sagittal Control- Overjet reductionIntermaxillary Class II elastics- Cooperation
Intermaxillary Class II elastics
O.SANDIDNon-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Impacted Maxillary CanineOpen space
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Molars distalization
Maxillary canine impaction
O.SANDIDNon-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Facial Mask- Cooperation
O.SANDIDNon-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Vertical ControlUnlocking growth of mandible
Vertical ControlUnlocking growth of mandible
BEFOREAFTER
O.SANDIDNon-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Levelling of the curve of Spee on the proclination of mandibular incisors
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Levelling of the curve of Spee on the proclination of mandibular incisors
Respect angulation of lower incisors on mand plane (Tweed triangle)
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Levelling of the curve of Spee by the proclination of mandibular incisors and expansion of dental arches
http://simpliclearpro.comNon-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Molar distalization- Cooperation
Headgear Mini-implant
Pendulum Lip BumperNon-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Tooth Stripping" - Interproximal enamel reduction
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Le déblocage de la croissance mandibulaire Unblocking of mandibular growth
Le déblocage de la croissance mandibulaire Unblocking of mandibular growth
AvantApres
O.SANDID
Le déblocage de la croissance mandibulaire permet a la mandibule de s’ épanouir en évitant l’encombrement dentaire, et l’installation de la
rétrognathie mandibulaire, d’où l’intérêt des traitements interceptifs
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Correction Oral Habits
swallowing pattern
Swallowing Pattern
Finger Sucking Mouth breathing
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Extractions Contreversies in Orthodontics
Indications – Part 1 M. ABOUELNASER
Time 30 minutesNon-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Les bénéfices du traitement orthodontiqueBenefits of Orthodontic Treatment.
Le praticien espère obtenir:• Une Amélioration Esthétique
Du Sourire, Du Profil rétrusif, Ou prognathique…
• Une Amélioration Fonctionnelle De l’occlusion, Du parodonte, De l’ATM…
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Extraction versus Non-Extraction
Le débat dure depuis plus de 100 ans, et ca continue, c’est le sujet le plus de controversé en
OrthodontieE. Angle le père de l'orthodontie croyait fermement dans le traitement non-
extraction. C. Tweed, a observé que certains patients traités par Angle présentaient une
quantité notable de récidives, a retraité un certain nombre de ces cas en extrayant quatre prémolaires, pour plus de stabilité …
Le débat dure depuis plus de 100 ans, et ca continue, c’est le sujet le plus de controversé en
OrthodontieE. Angle le père de l'orthodontie croyait fermement dans le traitement non-
extraction. C. Tweed, a observé que certains patients traités par Angle présentaient une
quantité notable de récidives, a retraité un certain nombre de ces cas en extrayant quatre prémolaires, pour plus de stabilité …
Edward Angle Charles Tweed
Bousaba S, Delatte M, De Clerck H. Rev Belge Med Dent (1984). 1995;50(2):53-65 .Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Extraction versus Non-Extraction
Part 2: Non-extraction Philosophy, Space regaining. Part 3: Choice of teeth for extraction.
Part 1: Extraction in Orthodontics and its Indications.
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Extractions in Orthodontics Indications
1-Indications: Severe dental crowding > 7mm-Tooth-arch discrepancy2-Indications: Anteroposterior relationships discrepancy. 3-Indications: unfavorable position of Tooth impaction, Dental ankylosis . 4- Indications: unaesthetic facial profile, Protrusion.5- Indications: Adult crowding with gingival recession.6- Indications: Dental Caries.7-Indications: Supernumerary teeth8- Indications: Patients not motivated and we need to shorten duration of treatment.9-Indications: Hyperdivergent facial type – vertical growth pattern.
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
1-Arch length- Severe Dental Crowding > 7mm
Tooth-arch discrepancy: Size of the jaw is smaller than the size of the teethDental crowding can be simply defined as the overlap of teeth caused by insufficient space within the dental arch.If the dentition is too large (Macrodontia) to fit in the dental arch without irregularity, it may be necessary to reduce the dentition size by the extraction of teeth.
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
2-Indications: Severe Skeletal Class II Correction of Occlusion Reduce overjet
Anteroposterior relationships ( Problem in patient cooperation, elastics, functional appliances, headgear… )Overjet is also known as “protrusion” of teeth, the lower teeth are too far behind the upper front teeth. In most Class II cases with abnormal upper proclination, it is advisable to extract teeth (14-24) only in the upper arch and to retract the maxillary incisors and canines. In case of the lower arch crowding it is advisable to extract in both the arches (34-44).
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
2-Indications: Severe skeletal Class III malocclusion Reduce Reverse Overjet
www.orthofree.com
REVERSE OVERJET IMPORTANT Class III cases are usually treated by extracting teeth only in the lower arch to discourage the forward growth of mandibe (34-44) Or surgery (15-25-34-44)
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
2-Décalage des bases osseuses- Classe III squelettique- Overjet inverséSkeletal Class III malocclusion- Reduce Reverse Overjet
www.orthofree.com
Dans le cas de Classe III squelettique, les extractions sont envisageables pour Réduire le surplomb inversé, Extractions de ( 34-44) ou ( 34-44 et 15 et 25 ).
Diego Rey Mora, Giovanni Oberti, PROGRESS in ORTHODONTICS Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
2-Indications: Severe Openbite, hyperdivrgent
Reduce Openbite- Reduce lower facial height
Before Trt
After Trt Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
2- Sévère Béance, hyperdivergence Severe Openbite, hyperdivrgent
Cas De Sévère Béance, Hyperdivergence, Les Extractions Entraîne Une Réduction De La Béance Et une Diminution De L’étage Inferieur De La Face
Avant Trt
Apres Trt www.orthofree.com
2-Indications: Midline correction, Dental asymmetry
Correction of Occlusion, Dental asymmetry, Midline correction
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
2-Correction des asymétries et de la ligne médiane Midline correction, Dental asymmetry
Guilherme JANSON, José Eduardo Prado de SOUZA, J Appl Oral Sci. 2009;17(4):354-63
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
3-Impacted teeth - unfavorable position
Impacted Canine, Root Proximity, Root resorption
Unfavorable position
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
3-Impacted teeth - Unfavorable position
Impacted molars, Root Proximity, Root resorption
Unfavorable position
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
3-Indications: Dental ankylosis
Tipping of teeth toward the ankylosed tooth and we need surgical intervention.
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
4-Biprotrusion - Convex Profile
Before Trt After Trt
LIP POSITION: Incisor inclination
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Biprotrusion
Reduce Biprotrusion, Gingival recession
Before Trt
After Trt J Canon –orthofree.com
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
4-Protrusive profile and gingival recession, lower incisor inclination on mandibular plane.
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
4-Position de l'incisive inférieure par rapport au plan mandibulaire, soutien osseux
Lower incisor inclination on mandibular plane 90°.
www.orthofree.com
Quand on ne peut pas vestibuler incisive inférieure, tissu de soutien faibleNous envisageons un traitement par extractions ,
La Position de l'incisive inférieure par rapport au plan mandibulaire nous donne des indications sur la nécessite ou non d’extraire , on compare cela à une personne qui avance sur un balcon au au-delà
de certaines limites la personne risque de tomber…
90°
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Agenesis compensationNon-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
6-UNHEALTHY TOOTH
6- Indications: Caries, Decay
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
6-Delabrement dentaire-Caries Unhealthy tooth
Extraction des dents carieés et préferable est indiqueé dans le plan de traitement orthodontique…
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
7-Supernumerary teeth
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
8-Patients motivation
Indications: Patients not motivated- shortening duration treatment, headgear wear, missing appointments
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
8-Manque de coopération et de motivation du patient Patients not motivated
Le manque de motivation du patient: Non port des élastiques, des forces extra-orales , des appareillages
fonctionnels etc…
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Serial extractionGuidance of Eruption
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Traitements interceptifs -Guidage de l’éruption Early Treatment - Guidance of Eruption
Le Guidage de l’éruption: L’extraction précoce des canines lactéales et dans certains cas des premières molaires lactéales, permet d’éviter l’inclusion des canines,
D’où l’intérêt des traitements précoces interceptifs ….
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Retard d’ éruption des dents définitives Delayed eruption of permanent teeth
Extraction de dents lactéales quand il y a Retard d’ éruption des dents définitives
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Retard d’ éruption des dents définitives Delayed eruption of permanent teeth
Une patient s’est présenté a l’âge de 8 ans, retard d’éruption, la panoramiqueMontre l’existence de dents surnuméraires , d’où l’indication des extractions afin de
Guider l’ éruption des dents définitives
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Non Extraction Extraction
Profil ConcaveConvexe
Typologie faciale Hypodivergenthyperdivergent
Avant de décider le traitement par extractions il faut tenir compte du profil et de la typologie de croissance du patient
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Non Extraction Extraction
Position de l’incisive inférieure
Etat parodontal
Apnée du sommeilPerméabilité des voies aériennes
supérieures
Avant de décider le traitement par extractions il faut tenir compte de la position de l’incisive inférieure, l’ état parodontal, et la prédisposition a l’apnée du
sommeil…
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Non Extraction Extraction
Stabilitétraitement
orthodontique, Récidive
Réduction amélaire proximale,
Stripping, Formes des couronnes
Penser à la stabilité du traitement et au facteurs de récidives ainsi que de la possibilité d’envisager une réduction amélaire proximale
ou stripping, en fonction de la forme coronaire
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Extractions Contreversies in Orthodontics
Part 3: Choice of teeth for extraction.
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
CHOICE OF TEETH FOR EXTRACTION
• 1st Upper Premolar Extraction • Extraction of two lower premolars• Extraction of 4 premolars• Lower incisor extraction• First molars extractions• Wisdom teeth extractions• Tooth impaction Extraction
Unfavorable position
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Choice of teeth for extraction.
1st Upper Premolar Extraction in Orthodontics- 51%
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Camouflage treatment in adult skeletal Class III cases byextraction of two lower premolars
Extraction of two lower premolars
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Crowding- Extraction of 4 premolarswww.orthofree.com
M.D MCNUTT
Extraction of 4 premolars 11%
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Crowding- Extraction of 4 premolarswww.orthofree.com
M.D MCNUTT
Extraction of 4 premolars 11%15-25-34-44
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Crowding- Extraction of 4 premolars
M.D MCNUTT
Extraction of 4 premolars 15-25-35-45
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Orthodontic treatment with lower incisor extraction
.
Overeruption and attachment loss of tooth 31.
Kenza LAHLOU Aalloula EL HOUSSAINE
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
First molars extractions
Dr Lemay-http://www.orthodontisteenligne.com/blogue/extractions/ Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Second Molar Extraction
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Wisdom teeth extractions (7%)
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Impacted Maxillary Canine-Extraction
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
\
Traitements orthodontique sur des vrais jumellesTwins treated by different orthodontic techniques.
Dr Alan Bagden
Dr Bagden a expérimenté 2 traitements sur des vrais jumelles avec et sans extractions, résultats, profil est concave pour le cas traité avec extractions
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Relation entre extractions dentaires et l’apnée du sommeil ? Relationship Between Extractions and Sleep Apnea ?
Extractions en orthodontie et constriction des arcades dentaires, Le volume destiné a loger la langue a été réduit, pas suffisamment d’études
pour quantifier l’incidence sur la perméabilité des voies aériennes supérieures , tout dépendra s’il y a mésialisation des dents vers le site
d’extraction ou recul du bloc incisivo- canin ?
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Extractions et durée de traitement
Les extractions en orthodontie reduisent - Elle la durée du traitement ou la rallonge ?
http://www.dr-alexandrian-stella.chirurgiens-dentistes.fr/les-conseils-de-lorthodontiste/un-traitement-en-orthodontie-dure-combien-de-tempsNon-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Conclusion
EXTRACTIONS Non Extraction Compromis
Plus j’apprends moins je sais ?Je sais que je ne sais rien, mais je le sais!
Socrate
لليل قق قلل لإ لم لل لع لل ا لن لم لم تت لتي تأو قما قو
Non-extraction Orthodontic therapy-oussama sandid- olivier sandid -o sandid-mohamad aboualnaser-mohamad aboulnaser-m aboualnaser
Bibibliographie
1. Aras A. Class II correction with the modified sagittal appliance and maxillary second molar extraction. Angle Orthod. 2000 Aug;70(4):332-8.2. Basdra EK, Komposch G. Maxillary second molar extraction treatment. J Clin Orthod. 1994 Aug;28(8):476-81.3. Basdra EK, Stellzig A, Komposch G. Extraction of maxillary second molars in the treatment of Class II malocclusion. Angle Orthod. 1996;66(4):287-91.4. Bishara SE, Burkey PS. Second molar extractions: a review. Am JOrthod. 1986 May;89(5):415-24.5. Cavanaugh JJ. Third molar changes following second molarextractions. Angle Orthod. 1985 Jan;55(1):70-6.6. Chapin WC. The extraction of maxillary second molars to reducegrowth stimulation. Am J Orthod Oral Surg. 1939;11:1072-8.7. Chipman MR. Second and third molars: their role in orthodontictherapy. Am J Orthod. 1961 Jul;47(7):498-520.8. Graber TM. The role of upper second molar extraction inorthodontic treatment. Am J Orthod. 1955;41:354-61.9. Graber TM. Maxillary second molar extraction in Class IImalocclusion. Am J Orthod. 1969 Oct; 56(4):331-53.
Extractions in Orthodontics www.orthofree.com
Bibibliographie 10. Haas AJ. Let’s take a rational look at permanent second molarextraction. Am J Orthod Dentofacial Orthop. 1986 Nov;90(5):361-3.11. Harnick DJ. Case report: Class II correction using a modifiedWilson bimetric distalizing arch and maxillary second molarextraction. Angle Orthod. 1998 Jun; 68(3):275-80.12. Henriques JFC, Janson G, Hayasaki SM. Parâmetros para aextração de molares no tratamento ortodôntico: consideraçõesgerais e apresentação de um caso clínico. Rev Dental Press OrtodOrtop Facial. 2002 jan-fev;7(1):57-64.13. Jäger A, El- Kabarity A, Singelmann C. Evaluation of orthodontictreatment with early extraction of four second molars. J OrofacOrthop. 1997 Feb; 58(1):30-43.14. Jones H. Second molar extraction therapy - two case reports.Funct Orthod. 2000 Winter;17(1):17-20.