Is orthodontic expansion possible after premolar extractions?

Question

Hi doctor,

When I was 8 years old, I had my upper and lower premolars extracted as part of orthodontic treatment. Over time, the extraction sites closed completely, which resulted in my jaws developing with reduced dental and skeletal support. As a result, I am now experiencing several functional issues.

At 21, I have a deep bite, a relatively small jaw, and minimal tongue space. I also encounter breathing and sleep-related problems, which may be linked to the reduced jaw size and compromised oral volume following the early premolar extractions.

I want to explore the possibility of orthodontically reopening the upper and lower premolar spaces and replacing the missing teeth with dental implants.

My goals are not only to restore the missing teeth but also to improve bite function, create more space for my tongue, and enhance overall oral and airway function.

I am particularly interested in whether a treatment approach using a Hyrax expander (or MARPE if indicated), a Beneslider, and fixed orthodontic appliances could be suitable for my case.

I would like to know if this combination could help achieve transverse and sagittal expansion, correct my deep bite, and create stable, sufficient space for future implant placement.

I am seeking an honest, professional evaluation of whether this type of treatment is feasible for me and whether it is worth pursuing further.

Please advise.

Answer 1

Hi,

Welcome to icliniq.com.

I fully understand your case. You mentioned your interest in using a Hyrax expander and fixed orthodontic appliances for your treatment. You are seeking to understand if this combination can effectively achieve transverse and sagittal expansion, correct a deep bite, and create sufficient space for future implants. This approach can be beneficial.

The decision to extract teeth was not ideal from the start. I am curious about the situation when you were eight years old. Were the premolars not yet present (which typically occurs between ages 10 and 12)? Was it a serial extraction procedure performed by a pediatric dentist or a general dentist rather than an orthodontist?

We can address all your needs with current orthodontic mechanics, which have developed significantly. We can reopen the space to allow for tooth proclination, creating more fullness and support for your lips, and expand the jaws to provide more room for your tongue, among other things.

To proceed with a detailed treatment plan, I need full data and records for your case. Please arrange a video consultation after gathering all the necessary documents so I can provide you with my comprehensive plan.

I hope this explanation is clear and helpful. Please feel free to ask any questions at any time; we are always here to support you.

Thank you.