METHOD OF HEALTHY TEETH EXTRACTION IN ORTHODONTIC TREATMENT
Authors: Kuroiedova V.D. , Nelyubina A.L. , Kravchuk H.A. , Doskovska A.V. , Pomortseva K.L. , Hutovska I.O. 
Published: December 2021

In the treatment of orthodontic patients, the most difficult and controversial is the question of removing healthy teeth. The aim was to evaluate the 30-year orthodontic clinical experience of the staff of the Postgraduate Education Department of Orthodontists for the use of medical methods of removal of individual healthy teeth in the treatment of dental anomalies.

The aim of our study is to evaluate 30 years of orthodontic clinical practice of the staff of the Postgradu- ate Education Department of Orthodontists for the use of medical removal of individual healthy teeth in the treatment of dental anomalies.

1340 dental outpatient cards of orthodontic patients who underwent orthodontic treatment and completed it with a positive result were reviewed at two clinical bases of the Postgraduate Education Department of Orthodontists.

The analysis of selected outpatient cards was performed taking into account the age and sex of patients, as well as depending on the type of pathological occlusion (according to Angle) and the type of teeth removed. Cards of patients with Angle's class I and II pathology were selected for scientific analysis.

241 patient underwent tooth extraction at both bases in total in terms of treatment, which is 17.99%. The number of patients with removed temporary teeth was 59.39% (143/241), patients with removed permanent teeth - 40.7% (98/241).

Permanent teeth were removed 1.45 times more often at the clinic "Orthodontist", which is explained by the higher frequency of requests for orthodontic care from adults and adolescents.

On the basis of the Postgraduate Education Department of Orthodontists, patients with deciduous teeth predominate - 69% (51/74) against 45% (75/167) in the clinic "Orthodontist". This is due to the fact that the main contingent of patients who seek help from the department are patients in the age of variable occlusion, which means that the Hotz method and the author's method of corrective removal of temporary molars are used more often.

A detailed analysis of the documentation of patients was performed at the base of the Postgraduate Edu- cation Department of Orthodontists who were treated with the use of individual teeth extraction by periods of occlusion. Children in the period of the first half of the variable occlusion accounted for 39.19% (29/74), chil- dren in the second half of the variable occlusion - 25.67% (19/74), and patients older than 13 years - 35.14% (26/74).

In female patients, regardless of age, tooth extraction is performed 13% -15% of cases more often than in men, which is due to a more attentive attitude to the appearance of girls by their parents.

Among patients with various types of pathological occlusions treated with the method of removal of individual healthy teeth, children, adolescents and adults with Angle class I occlusion pathology accounted for 53.94% (130/241). Assessing the frequency of application of the method of extraction of healthy teeth by age, we can say that in pathology of class II according to Angle most often the method is used in patients with permanent occlusion in 38.73% (43/111).

In the treatment of pathology of class I according to Angle, the removal of healthy teeth is twice as often performed in alternating occlusion than in permanent. In the treatment of pathology of class II according to Angle, the method of removing individual teeth is more often used in patients with permanent occlusion.

Research on the consequences of removing individual healthy teeth in orthodontic treatment is relevant and timely. Both in the private sector of orthodontic care and on the clinical basis of the Postgraduate Education Department of Orthodontists, about a fifth of patients of any age and any orthodontic pathology are treated orthodontically using the clinical method of removing individual healthy teeth.