Reversing premolar extractions in Europe

[dentes]

Hi ArchWired! I hope anyone reading this is doing well!

I am an adult patient in my early 30s that foolishly underwent four premolar extractions one and half year ago based on the advice of my orthodontist. Unfortunately, the result has been very poor, both from a functional aspect and from an aesthetic aspect.

I know that it might sound weird but I now feel like I don't have enough space for my tongue, mainly in my lower jaw. For some reason my right nostril is also obstructed for more or less half the day these days, I did not have this problem before starting my orthodontic treatment. A sleep study showed that I have mild sleep apnoea, to be fair I may have had this before the extractions but I doubt that extractions and the subsequent retraction helped in this regard. I also suffered complete bone loss in one of the upper extraction sites and the orthodontist has been unable to close this gap. Perhaps this is good for my tongue, but as a consequence of this I have a large overjet and lip incompetence.

My aesthetic concerns are mainly that my face has become noticeably narrower after the extractions, two people actually commented on this indirectly by asking if I had lost weight because apparently "my face looked skinnier", and that optimally my chin/lower jaw would be set a little more forward (I know, reversing extractions in itself would not correct this, going in to all of this I was probably a surgery candidate).

Anyway, I have been researching what treatments I should consider going forward and a couple of forums threads on reversing extractions led me to this message board. All of these threads seem to involve patients in North America or Australia/New Zealand.

Has anyone reversed extractions in Europe or know of any practitioner in Europe that actually does this? All (not “all” as in “many” though...) of the orthodontists/dentists that I find that claim provide this treatment seem to be located in the USA.

The whole topic of reversing premolar extractions also has me quite confused to be honest. On the one hand there are practitioners offering the treatment and patients that claim to successfully have completed it. On the other hand I struggle to find any academic literature on the treatment.

Any help and guidance that any of you reading this could offer would be very much appreciated, honestly my current mouth situation has had me feeling quite depressed lately.

[pcspinheiro]

Even though I stopped my "treatment" halfway, I know about extraction regret, as I stopped too late and had already pointlessly lost one premolar. Beware though that thinning of the face is normal with braces as we can't chew properly and lose muscle mass. The other issues aren't though, and are certainly a cause for concern. In my case, solving the upper crowding improved my breathing, and extraction-retraction would certainly have been disastrous. I never thought I needed extractions and did it against my will and better judgment, but at the time, knowing nothing about orthodontics, I was literally bullied into doing it "because it was the only way" according to my former idiot ortho. Still hate her for that. Now I'm braced again but will never have a proper outcome since I will obviously never extract the contralateral tooth nor am I at all keen for an implant... so space closure it is, with some loss of midline symmetry. Who cares when you lived 40 years with crooked teeth... Hope you can sort out your case in the best possible way!

[Ren290]

Hey,

I was in the same situation and very desperate to 'reverse' it and also looked for doctors in Europe who would do it. However, each case is different. And I talked to various professionals, and technically it is possible but no one can really say if you will be able to achieve the amount of space required to get the implants; it's also not healthy to stretch out your teeth like that and most orthodontists would probably think its too risky ( and besides, its very expensive).
Anyway; my smile turned very narrow during my treatment and I switched to another orthodontist;she was very experienced and made me new braces (incognito) to expand my arches, bring the teeth outwards as far as possible; and it was successful. My smile wasn't as broad as before the extractions, but I am satisfied.

So, the only advice I have, explore alternative options such as widening the arches and bringing teeth forward with braces. It might be a compromise ( and way cheaper/ less risky). And don't stop looking for an orthodontist who really understands what you want and who is on top of his/her game. Maybe someone who is a professor at a Uni, has decades of experience, and so on.

[dentes]

[quote=pcspinheiro post_id=507617 time=1558723938 user_id=29127]
Even though I stopped my "treatment" halfway, I know about extraction regret, as I stopped too late and had already pointlessly lost one premolar. Beware though that thinning of the face is normal with braces as we can't chew properly and lose muscle mass. The other issues aren't though, and are certainly a cause for concern. In my case, solving the upper crowding improved my breathing, and extraction-retraction would certainly have been disastrous. I never thought I needed extractions and did it against my will and better judgment, but at the time, knowing nothing about orthodontics, I was literally bullied into doing it "because it was the only way" according to my former idiot ortho. Still hate her for that. Now I'm braced again but will never have a proper outcome since I will obviously never extract the contralateral tooth nor am I at all keen for an implant... so space closure it is, with some loss of midline symmetry. Who cares when you lived 40 years with crooked teeth... Hope you can sort out your case in the best possible way![/quote]

Thank you for your comment! And sorry for my belated reply. As I let on in my previous post, the state of my mouth has had me feeling quite depressed and as a way of coping I have, as of late, taken the ostrich approach and tried to ignore the problem as best I can. An unwise strategy that hasn’t been working particularly well. Hence, my belated reply.

I was sorry to read about your treatment outcome! In all that I guess that you are “lucky” in that you took charge when you started having doubts about the treatment plan and managed to stop halfway. I hate myself every day for not doing enough research before starting the treatment, for not consulting with more than one orthodontist.

I must also say that, and I hope that I don’t come across as selfish by saying this, it feels a little consoling to read that I’m not alone in facing these issues. I obviously knew beforehand that I’m not alone in having had an adverse outcome to extraction orthodontics (as I also know that many patients are fine) and I wish that you hadn’t undergone the treatment considering your outcome, but nevertheless your post was comforting to read, so thanks once again for your comment.

Btw, why are you not keen on an implant?

What has changed for me since my initial post is that I’m now de-braced. All the problems that I mentioned in my original post however persist. The perceived lack of tongue space, the 11 mm overjet, lip incompetence, the nasal obstruction etc. You mentioned a loss of midline symmetry in your reply and I’m in the same boat there as well. My philtrum is off centre due to the lack of bone in one of the upper premolar extractions sites.

Still haven’t had any luck in finding anyone in Europe that reverses extractions. Although I haven’t really been researching that since my first post.

I have been thinking about sending an email to IAFGG enquiring about recommendations for orthodontists. Feels a bit like a longshot though, seems like they are focused more on younger growing patients.

I have also been entertaining the thought of actually going to the USA for a consultation. More for a sense of hope than anything else. To see if anything can be done to remedy my problem. Not that I see how the heck I’m going to afford the necessary treatment though. Sigh…

[dentes]

[quote=Ren290 post_id=507701 time=1560609295 user_id=32838]
Hey,

I was in the same situation and very desperate to 'reverse' it and also looked for doctors in Europe who would do it. However, each case is different. And I talked to various professionals, and technically it is possible but no one can really say if you will be able to achieve the amount of space required to get the implants; it's also not healthy to stretch out your teeth like that and most orthodontists would probably think its too risky ( and besides, its very expensive).
Anyway; my smile turned very narrow during my treatment and I switched to another orthodontist;she was very experienced and made me new braces (incognito) to expand my arches, bring the teeth outwards as far as possible; and it was successful. My smile wasn't as broad as before the extractions, but I am satisfied.

So, the only advice I have, explore alternative options such as widening the arches and bringing teeth forward with braces. It might be a compromise ( and way cheaper/ less risky). And don't stop looking for an orthodontist who really understands what you want and who is on top of his/her game. Maybe someone who is a professor at a Uni, has decades of experience, and so on.
[/quote]

Thank you very much for your informative reply!

Prompted a lot of questions, I hope you don’t mind me asking them.

- You mention expensive, what were the quotes that you got for the cost of reversing extractions with implants?

- What risks in particular did the professionals that you consulted inform you about?

- Were you and your orthodontist able to expand both the maxilla and mandible? How many mm’s of expansion did you manage to attain? In which directions? Both “width” and “depth”/”length” of the dental arch or only width?

- Do you have any recommendations for particular orthodontists/clinics in Europe/your country?

Once again, thanks for your reply! Glad to hear that you, all things considered, are satisfied with the expansion that you and your orthodontist managed to achieve.

[americaninparis]

Here's a survey on extraction consequences that might interest you: https://drive.google.com/file/d/1O0_EIJ ... be7Yx/view


As for reversing in Europe: there is one doctor in Germany, a couple in Spain, and one in Italy I know about. I myself have had braces to expand (not enough) and am now in MSE for bone expansion of the palate.

I will be putting up a website including lists of practitioners worldwide, as well as videoed interviews with each of them, from Dr. William Hang to Dr. Derek Mahony to the Mews, so you can see exactly what is offered.

There will also be victim interviews (in case anyone is willing to share their story, do let me now), as well as an overview of each treatment plan: from MSE to FAGGA to SFOT.

It should be up in the next couple years. If you are desperate in the meantime, do write me a message! Reversal is a growing field.

[americaninparis]

p.s. you can get 4-5 mm lateral expansion with braces alone, and 3 mm anterior expansion. With palate expanders you can get substantially more, and with MSE you can get up to 7 lateral.

The big trick is matching the mandible to the maxilla, as the maxilla can be expanded more than the mandible.

In this case, distraction osteogenesis and SFOT have been recommended.

Implants are considered the ideal goal.

[zara247]

Hi there, would you be able to share any names/contacts for the orthodontists in Europe? Thanks so much!

[entelechy12345]

Europe:

Ela Banica in Bucharest Romania: expanders, MSE, opening teeth for implants, trained by Bill Hang and the Mews
S. Friedlander in Barcelona, Spain: MSE, SFOT, Invisalign
Fareed Khan in London, UK: Invisalign

a few others here and there, who can do "something"

Christoph Moschik: Relax and Smile in Munich, Germany - Just MSE. Will not open spaces.
Charles Smith in Heidelberg: will open spaces with FAGGA, which is controversial and may damage teeth (but may work)
Tania Stakowski in Paris: may be willing to open spaces, but has no experience doing so

You might try the Reversal Extractions site on Facebook where people exchange other names.

Also, if you take my survey, survey takers get a full report on Extraction Consequences so you can diagnose your own case and figure out which method would work for you. Highly recommended, as you should know your own needs to a T, before accepting any plan---as mistakes have been made in patients. I also have a report surveying all reversal methods (30 pages) and will be getting that out soon to people who ask for it.

survey: https://forms.gle/F5LEdN9ujjiMu4Mt6

Plus you might want to read this article: https://karinbadt.medium.com/premolar-e ... aa115481bf

[gennie2000]

Hi there,

Can i just ask where you got these names from, and do you know if they have experience in extraction reversal?

Can you also provide any names of doctors in the UK familiar with this treatment?

Thank you so much

[djspeece]

Hi there,

Can i just ask where you got these names from, and do you know if they have experience in extraction reversal?

Can you also provide any names of doctors in the UK familiar with this treatment?

Thank you so much

You may have to create some more posts so that you can IM the person, above. As you probably realize this is a really old post (even most recent post is nearly a year old) so you may not see a response. I think you need to make seven posts or something in order to gain the ability to IM people directly. Best of luck to you, in any event!

[entelechy12345]

To get a thorough overview of extraction consequences, you can check this article:

https://medium.com/@karinbadt/premolar- ... 90344bc7bf

As for reversal: so many people are running into problems doing it. Jaw surgery may be an option to consider as surgeons are used to treating "extraction victims" .