Impact Of Symmetrical Extractions Of Premolars On Class ? Sub Division Malocclusion

Background:The purpose of this study was to study the Impact of symmetrical extractions of premolars on class 2 sub division with unilateral posterior cross bite and anterior crowding in an eighteen year old female who besides class2 sub-division also present with anterior crowding and unilateral posterior cross bite.Method:Pre-treatment photographs were taken followed by cast analysis and cephalometric analysis.Based on the results extraction of maxillary first premolars was done followed by MBT Edgewise arch wires in conjunction with Multi-loop edgewise arch wires(MEAW)were availed to reach the desirable results.Results:The treatment lasted for around 32 months resulting in class 1 molar and canine relationship with elimination of the unilateral posterior cross bite.The anterior crowding and midline discrepancy was also corrected with good occlusion.Discussion:Treatment of Sub-Division cases can be difficult to treat as they are usually associated with the midline shift or midline discrepancy.Besides in most cases there will be arch width and tooth material discrepancy also which is manifested in different forms of anterior/posterior,unilateral/bilateral cross bites,anterior class 1 or class 2 relation or an open bite tendency.In this case almost everything is present.And for the same reason an orthodontist is compelled to use multiple approaches to deal with these problems effectively.Conclusion:Our findings suggest that extraction of maxillary first premolars and mandibular second premolars followed by tooth movements availing different approaches available,In our case MBT edgewise and MEAW can be very effective in treating a class2 subdivision with unilateral posterior cross bite and anterior open bite tendency.