PDF: Frequency of orthodontic extraction

At the beginning of the twentieth century, when Orthodontics became a science, treatment plans were based on the premise that extraction destroys the possibility of ideal occlusion or ideal esthetics. 

orthodontic-extraction


For this reason, they were condemned by Edward Hartley Angle and his followers.

One of Angle's most important opponents was Calvin Case who defended dental extractions for correcting facial deformities due to excessive dental or maxillary protrusion. According to Case, extraction was necessary in 3% of cases that presented Class I malocclusion, in 5% of Class II cases and nearly 0% of Class III cases. Thus, considering the incidence of these malocclusions, only 6 to 7% of treated cases required extractions.

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In 1930, after Angle died, one of his followers, Charles Tweed, who had evaluated cases that had been previously treated without extractions, decided to retreat several cases that presented relapses. After analyzing the cases treated in accordance with Angle's philosophy, he noticed that 80% of his patients did not achieve stability, facial esthetics, periodontal health or functional objectives. For this reason, Tweed defended extractions as a method for achieving facial harmony and providing greater post-treatment stability. This finding caused a revolution in orthodontic thinking, and, by the end of the 1940s, extractions were reintroduced.

Between 1950 and 1960, dental extractions for orthodontic purposes became common in the United States. Approximately 50% of patients underwent orthodontic treatment with teeth extractions, usually first premolars.

After 1960, with greater acceptance of Begg's technique, orthodontists who did not employ the Edgewise philosophy adopted this new technique and incorporated extractions into their orthodontic planning. At that time, dental extractions reached their peak and thereafter began to decrease considerably.

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