it's Dr Amanda with Street smile Solutions straight smilesolutions.com and let's talk a
little bit more about class 3 extraction pattern now of course of course of course I want you to
watch all my other videos on extraction patterns I have a class 2 video I have class one videos
you and you can watch them all they're in both my braces and my Invisalign playlist you can
access those just at my YouTube channel which is straight smile Solutions put that in the
search bar take you down on the home screen and you're going to see all these different playlists
so make sure you watch those videos first before you watch the other videos but today we're going
to specifically talk about class 3 extraction patterns now of course I gotta say this again
I do not believe in extracting teeth unless it's absolutely 110 necessary how do you know well of
course you're going to have to get a ceph don't have a SEF shouldn't be taking out teeth because
then you don't know if you really need it if it's a growing child you probably don't need it and
you probably shouldn't be doing it that's sloppy that's lazy that's you being lazy not wanting to
do proper Orthodontics do what you need to do expand the Arches use a face mask that is the
right way why condemn a child to having a poor Airway for life and perhaps shorten their life
when you can do your Orthodontics properly okay so I'm gonna assume and I hesitated making this
video for many many many years just because I'm so anti-extraction but there's an occasional one
off where we need to do it so for that reason I'm going to make this video and this video is
only for those adults who refuse jaw surgery and have refused it in writing and they are
very slightly class three not surgical class three very slightly class three well sorry I
should rephrase that slightly class three three that we can do it enough and still get a decent
enough result with extraction if it is a severe cluster you do not even attempt it it's a no you
just say no thank you because you're going to make them look and function worse just to have
straight teeth which is below standard of care which could potentially affect their ability to
eat talk negatively breathe sleep negatively that is a liability for you and you need to know these
things as the dentist or the orthodontist that if you mess with basic functions in the patient that
is a lawsuit and that's just how it is so too many times dentists just say oh well patience demanding
have straight teeth they don't care if their bite is wrong well you should care if their bite is
wrong and you should say this is not the right thing to do okay I'm gonna say this before any
extraction video so I want to bang it through your heads because you guys are contacting me
every single week telling me I want to take out teeth and I'm like why why do it the right way
or just don't do it you don't they can't force you to take out teeth so anyways Okay so we've
assumed you've taken your Seth we're assuming you have your SEF number we're assuming this is
an adult who can no longer grow who has gone to the orthodontist who has had a consultation to
do orthognathic surgery and has declined it you have found a way to possibly take out some teeth
and to give them a better result so it's better in both look and function okay and this is where this
thing comes up so there are three major extraction patterns to class 3 patients who are non-growing
one of them for very very severe is lower Force okay lower force that means lower first premolars
only that is if you have a very severe half to full step class three you probably will need to
put in some additional Anchorage for my clients I always recommend a lingual Arch you keep that
in during level in line you keep that in until you retract lower canines you pull those canines back
then you go ahead and undertie those canines to the rest of the teeth in the arch the posterior
teeth the fives the sevens and the sixes and you under tie them and make them one big unit
and then it should be it should be money if you picked your case wisely and you didn't over pick
a case that was too hard it should work out just peachy should work out really well you
should get nice positive overjet lower insiders might be a little retrocline that's okay that's
what goes with it profile is going to probably not be great but they're still going to look
and function great that's lower Force then we got another one upper four is lower fives upper
Four's lower fives is four premolars coming out this is for a very slight class three like with
but with a lot of crowding um and also one more thing I have to mention is that in a lot of these
cases if you do go to Invisalign you can take out eights which is third molars and you can use
some sequential distalization instead of taking out premolars which is a lot less drastic and
dramatic I can't do that easily in braces only in good aligners like Invisalign so if you do
Invisalign sometimes you can avoid this extraction sequence this is for patients that are demanding
for whatever reason can't have Invisalign refuse to have third molars out gotta have braces so
upper fours lower fives is for that one to two to three millimeters Max class three ish um if
it's more like one you won't need the lingual arch for Anchorage if it's more like three you probably
want to put the lingual arch in for Anchorage you keep that legal arch in until you've retracted the
canines to class one then you go ahead and under tie them okay and close the rest of the space
um if it's something way more severe you could always do pads this is not something I teach it
is Way Beyond what I think a general and pediatric dentists know and to be honest
I don't even have that much experience with it it's such a one-off in most of these cases
again I'm going to do surgery why because I can I'm an orthodontist it's the right thing
to do why do I want to get a extra Compromise result and potentially lose my license so I'm
not going to do tax but some people will say but what about tats okay fine yeah you do tads pass
um if it's very mild mild look it's just a hair what less than a million millimeter class three
no real upper crowding only crowding has lower anteriors then that would be a lower incisor or
you can dissolize sequential distillation is my favorite so so much easier than extractions so
those are your three different extraction patterns I hope that was helpful and have a great day