Excerpt from The British Journal of Dental Science, 1884, Vol. 27
The extreme importance of the question how crowded dentures should be treated has given rise to much discussion upon the subject, and has occasioned great diversity in the methods adopted in the treatment of these cases.
It would be beyond the scope of this paper to enter into the consideration of these methods, so that it must suffice to say that most practical men, while differing materially in their after treatment, yet agree that the extraction of one or more teeth is in most cases obligatory, unless expansion of the arch by mechanical means would suffice without removal of any.
Some dentists remove one of the bicuspids in preference to the first molar, and it is in this paper my object to show that the rule is based upon wrong or imperfect data, as I trust the sequel will prove. Crowded dentures are commoner now-a days than was the case formerly, and by removal of one of the bicuspids the irregularity may be rectified by mechanical means for a time, until the eruption of the third molars, when the teeth resume more or less their old position, and so cause a secondary deformity, and it is with a view to avoid the oc currence of these lamentable cases that I have endeavoured to ascertain whether any initial choice of teeth to be extracted may not achieve the object in view. It may be indicated that the table appended is compiled Wholly and solely from cases of persons from hospitals, dispensaries, &c., this being impor tant since it is among this class that but few teeth are removed to correct deformities, the patients, as a rule, valuing their teeth more than their appearance. Hence I may say that nearly all these teeth were removed for actual disease.
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