
Premolar extraction protocols Part 1 What you may not know…
I need my premolars extracted - are clear aligners suitable for me?
Premolar extraction protocols Part 1 - What you may not know…
Extraction cases with aligners is challenging and results in:
• Extrusion of incisors, mesial crown tipping of posterior teeth, intrusion of premolars (bowing effect) and uncontrolled tipping of incisors
• Bowing effect is commonly seen in extraction cases or when closing large spaces with aligners
• Mesial crown tipping of the posterior teeth and anterior extrusion during retraction.
In general, there are two types of extraction protocols
• “M Pattern” vs “Frog Pattern”
“M Pattern”
• One step protocol, retraction of canine followed by en-masse of anterior four teeth
• Canine distalise to middle of the extraction space and then all anterior 6 teeth retracts together
“Frog Pattern”
• Multi-step protocol, canine retracted to half of extraction space → incisors retracted until contact with canine → canine continue to retract half of the residual space → All anterior teeth then retracts at the same time
So...M pattern vs frog pattern Which one is better?





























