[Unilateral space-creating extraction in orthodontics]

Area of Science:

• Orthodontics
• Dental Surgery

Background:

• Unilateral space-maintaining extraction is a controversial orthodontic procedure with limited literature.
• Current literature provides few references on the attitudes and outcomes of this treatment approach.

Observation:

• The author reviews attitudes towards unilateral space-maintaining extraction.
• Extraction is generally discouraged on one side but may be a concession when space is insufficient for a premolar.
• Distal removal or molar extraction is indicated, requiring rigid archwires to prevent deformities and fixed anchorage for non-target teeth.

Findings:

• Excellent occlusion is typically not achievable with unilateral extraction.
• Maintaining the midline and preventing its displacement towards the extraction side is crucial.
• Post-treatment, wisdom tooth eruption can displace the midline.

Implications:

• Patients must be informed about potential visible consequences of unilateral extractions.
• Careful case selection and management are essential to mitigate risks associated with this procedure.