Braces then implants instead of closing extraction gaps?

[ichigo9]

Hi Everyone

I have a very narrow smile, with only the six front teeth showing. I also have crowding on my front teeth, with a high canine on one side. However, I've been told that my bite and occlusion are fine.

Recently, I had 4 bicuspids extracted. I don't have braces yet. I am now having second thoughts about the extractions. I can definitely see that a TON more space than needed has been created. My ortho's treatment plan is to align my crowded front teeth then retract them to close the extraction gaps. A LOT of retraction will be required because of the excessive space that has been created. I already have a narrow smile and this means that after braces, my smile will be even narrower, with fewer than six teeth showing. I wouldn't be happy with that result.

Also, my tongue is already constricted in my current arch size. I feel that if my teeth are retracted, then I will definitely have issues with tongue space, and the myriad of issues that could arise from it scares me.

Now that I've extracted my 1st premolars already, I definitely would like to straighten my front teeth; my issue is that I don't want excessive retraction. I'm happy with a compromised result, I don't need perfection. So I would like to know any of you think the following could be possible -

1) Straighten front teeth, then move the back teeth forward to close gaps. Could this be a viable, safe option?

2) Straighten front teeth and keep gaps open, then place implants/ bridges/ fake teeth in the gaps instead of closing them. Can this be done?

Thanks.

[Bikerchick85]

Hello! I am 11 months into treatment with 4 extractions. I had severe crowding upper and lower and a protrusive profile WITH the crowding. I had to strain to close my lips. I needed a little bit of retraction but told my ortho that mainly I wanted the back teeth moved forward to close gaps. She's done just that. My profile is normal now, and I've had no negative effects from extractions. You can click on this link to read my story and view pics... http://www.archwired.com/phpbb2/viewtop ... =9&t=43860
I'm not sure without seeing pictures of your teeth if you had the same issues as me.
Make sure you communicate with your ortho about your goals. Tell them you want a broader smile and that you don't want a lot of retraction. My ortho told me that the back teeth naturally moved forward while closing space anyway. They can control this movement. Speak up for yourself! You are ultimately the person in control of your treatment!

[ichigo9]

Hello! I am 11 months into treatment with 4 extractions. I had severe crowding upper and lower and a protrusive profile WITH the crowding. I had to strain to close my lips. I needed a little bit of retraction but told my ortho that mainly I wanted the back teeth moved forward to close gaps. She's done just that. My profile is normal now, and I've had no negative effects from extractions. You can click on this link to read my story and view pics... http://www.archwired.com/phpbb2/viewtop ... =9&t=43860
I'm not sure without seeing pictures of your teeth if you had the same issues as me.
Make sure you communicate with your ortho about your goals. Tell them you want a broader smile and that you don't want a lot of retraction. My ortho told me that the back teeth naturally moved forward while closing space anyway. They can control this movement. Speak up for yourself! You are ultimately the person in control of your treatment!

Thanks Bikerchick for your reply. I will definitely speak to my ortho about bringing my back teeth forward to close the gaps. I have checked your thread and my lower teeth look similar to yours, but my uppers are more crowded than yours (I have a high canine). I would like to know if you were advised of any risks of protracting the back teeth instead of retracting the front teeth to close the gap? Did your ortho have any reservations or conducting the treatment that way? Mine just didn't consider this at all initially.

[embraced13]

Like you I had my top 2 bicupods removed. Gonna get braced tomorrow ^^

Just like most of us, I was concerned with the removal of tooth. My ortho assures me my face profile would not be sunken as he will bring forward the molars and bring in my huge overbite.
Have a little faith!

[Bikerchick85]

Thanks Bikerchick for your reply. I will definitely speak to my ortho about bringing my back teeth forward to close the gaps. I have checked your thread and my lower teeth look similar to yours, but my uppers are more crowded than yours (I have a high canine). I would like to know if you were advised of any risks of protracting the back teeth instead of retracting the front teeth to close the gap? Did your ortho have any reservations or conducting the treatment that way? Mine just didn't consider this at all initially.

My ortho did not have any reservations about moving the back teeth forward, she just told me it takes longer to do this than to move front teeth backwards. She actually thanked me for giving her a challenge. LOL. In my case where my mouth is so small my upper arch molars were very far back and needed to come forward. They are so much easier to brush and keep clean now. I don't see any risks of moving the back teeth forward... they move forward naturally with retraction if there isn't something done to keep them in place. It is just more of a challenge. Good luck with your journey! Post pics!