Case report: four permanent second molar extractions

A patient who had earlier undergone four second molar extractions and who demonstrated Class II buccal segments and major incisor crowding was treated with the relatively unusual extraction pattern of maxillary lateral incisors. The treatment resolved the crowding and created Class II buccal segments with maxillary canines substituted for extracted lateral incisors. Favorable tooth anatomy produced an acceptable esthetic result accomplished with a predictable outcome over a reasonable duration of treatment. The sequential panoramic radiographs show evidence of the third molars spontaneously progressing toward positions that may result in their successful substitution for the earlier extracted second molars. A relatively unorthodox treatment plan made possible resolution of a difficult existing clinical situation using relatively routine treatment procedures.