Would adult bicuspid extraction for braces cause TMJ disorder?!


Question: Would adult bicuspid extraction for braces cause TMJ disorder?
Went to three consultations for metal braces (all suggested Damon). According to the orthos, I have bi-maxillary protrusion, overbite/deepbite, overjet and mild crowding and either class I or class II malocclusion (i don't remember). And was told that if I want to completely address everything, i would need to have 4 bicuspid taken out. But after doing a bit of research online, it seems that people have been saying that such extractions would later cause TMJ disorder? Is this true? Even if the braces were to be done correctly? If so, what exactly are the complications one would expect from bicuspid extraction? Thanks!!!

Answers:

Your question is a little difficult to answer without looking at a cephalometric analysis (one will be done, right?) All orthodontic patients should have a cephalometric analysis done to confirm the diagnosis and if the right type is used (there are many) it will also tell the orthodontist what can be done as well as what should not be done in order to prevent TMJ problems. The only time bicuspid extractions are indicated, IMHO, is in bimaxillary protrusion cases. Traditional orthodontists have not yet figured out that any ortho treatment that results in the mandible being forced too far posteriorly will cause TMJ problems. Therefore, as long as bicuspid extractions are done to eliminate the bimax profile but do not force the mandible back, then all should be well. However, if you do indeed already have TMJ, then that needs to be corrected while in braces. Dentists and orthodontists who have had functional orthodontic training will be the best ones to handle cases like yours. traditional orthodontists who do not have any knowledge of functional orthodontic technique will not be able to fix your TMJ problem. They will probably tell you that it "might" go away when everything is done. In other words, you have a 50-50 chance of your TMJ problem not being addressed or fixed and that will be a shame.

functional orthodontist; treated TMJ since 1984




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