Edentulous sites with early extraction due to dental caries, periodontal breakdown, trauma, congenital missing or restoration sites replaced with prosthetics bridges or dental implants are common clinical intraoral conditions in adults. While extraction of premolars is well-accepted and established as an orthodontic protocol to improve or to camouflage various malocclusions, with the increase of adult orthodontic population, orthodontists may confront compromised clinical situations that limit the decision to extract multiple natural and healthy premolars for orthodontic purposes only. In these cases, hopeless teeth or preexisting restorations can be extracted or removed instead of healthy premolars. Accordingly, asymmetric anchorage control and additional detailed managements to overcome the differences in tooth shape and size maybe necessary. This lecture will provide an overview of orthodontic and interdisciplinary managements to overcome atypical orthodontic extraction schemes other than premolars by looking into various adult orthodontic extraction cases. Clinical decisions to overcome the uneven/ asymmetric extraction scheme, clinical management to control 3-dimensional tooth movement and anchorage as well as to overcome the esthetic limitations will be shared with treatment outcome and long-term prognosis.


Learning Objectives
After this lecture, you will be able to understand the clinical options to make uneven/ asymmetric extractions in compromised adult orthodontic patients
After this lecture, you will be able to acknowledge clinical managements to control 3-dimensional tooth movement using TADs and to overcome the esthetic limitations in uneven/ asymmetric extraction cases.
After this lecture, you will be able to appreciate the clinical outcome and long-term prognosis following orthodontic treatment with uneven/ asymmetric extraction