Can we consider ALL of our patients' treatments without dental extractions?

The clearest answer to this question has only one word: NO.

No, if we want to ensure the final position of the teeth within their bony bases, avoiding recessions and fenestrations by displacing them totally or partially out of the jaws.

Although it is "logical" that patients "prefer" not to have teeth extracted, it is the orthodontist who must make the diagnosis: if the amount of bone in the jaws is X, and the size of the teeth to be placed in them is X+Y, it is logical to think that the problem cannot be solved without increasing the size of the bone (which in adults involves a surgical approach) or extracting teeth.

Given that "bone building" has only been tested in children or adolescents who are still growing, it would be logical to think that the increase in the number of treatments in adult patients will also increase the number of extractions.

It is important to remember that avoiding extraction of premolars in cases where it is indicated often leads to impacted third molars, which eventually need to be extracted even more complexly, so we should review our approach and reevaluate whether we should be more "strict" with extractions in cases of severe DOD.

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