SpeakerDr. Jeong-il Kim
Lectures 20
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7. Premolar extraction treatment

The extraction treatment sequence in MEAW is as follows: 

1. Leveling and alignment 

2. Space closure stage 

a. Maxillary canine retraction, 

b. Mandibular en-masse retraction, 

c. Maxillary anterior teeth retraction,

3. Finishing 

This lecture explains criteria to be checked and precautions to be taken at each stage.

Anchorage is important for extraction treatment, and can be divided into maximum

anchorage, moderate anchorage, minimum anchorage, and absolute anchorage.

In cases of severe crowding and protruded maxillary and mandibular teeth,

it is recommended to move the maxillary and mandibular anterior teeth backward as far 

as possible.

In the majority of cases such as moderate or minimum anchorage, it is recommended to

move the maxillary and mandibular anterior teeth to aesthetically pleasing positions and

move the molars forward to close the remaining space.

Each case was highlighted in the lecture to help understand how to secure the necessary

anchorage for space closure.

In the case of premolar extraction, the mandible is likely to be positioned backward,

so evaluation and adjustment are required.

To do this, in the case of extraction treatment, an understanding of retrusive control and

elimination of occlusal force is required.

The cases of premolar extraction were divided into U44, L44 extraction, 

U44, L55 extraction, U55, L55 extraction, only U44 or U55 extraction, and asymmetric

premolar extraction, and the lectures explain differential diagnosis and indications.

In addition, through the lectures, you will be able to understand bracket selection, strategic

bonding, and accurate bracket placement to be used in each case.

In the case of extraction treatment, the occlusal plane is also important, and the

classification and tooth movement according to the normal POP and steep POP is explained.

The precautions in the small-foot calibration procedure can also be understood.


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1. Space Closing Methods in MEAW (Part 1) 1) Sliding methods vs loop methods
2) Maxillary canine retraction
3) Strategic bonding for maxillary canine retraction
2. Space Closing Methods in MEAW (Part 2) 1) Lower En-masse retraction
2) Maxillary anterior teeth retraction
3) Stop doing list in space closure
3. Anchorage (Part 1) 1) Anchorage and discrepancy
2) Reinforce anchorage
3) Factors that affect the anchorage
4. Anchorage (Part 2) 1) Minimum anchorage and how to get it
2) Moderate anchorage and how to get it
3) Maximum anchorage and how to get it
4) Absolute anchorage and how to get it
5. Elimination of Occlusal Force (Part 2): Extraction 1) Difficulty in accurate bracket placement
2) Problem solving
2) Purpose of elimination of occlusal force in extraction case
3) Class II premolar extraction case
6. Retrusive Control (Part 3): Extraction Treatment 1) Retrusive guidance and mandibular adaptation
2) Retrusive control in extraction treatment
3) Class II premolar extraction case
4) Space closure for considering canine key
7. PEG (Premolar Extraction Guideline) Index 1) Dr. Kim's PEG index
2) Clinical cases throught PEG index
8. Guidelines for Premolar Extraction 1) Guidelines for Class I premolar extraction
2) Guidelines for Class II premolar extraction
3) Guidelines for Class III premolar extraction
9. Strategic Bonding for Extraction Treatment 1) Maxillay canine retraction and UOP change
2) Initial bonding on upper 1st premolar extraction
3) Initial bonding on lower 2nd premolar extraction
4) Initial bonding on lower 1st premolar extraction
10. U44, L44 Extraction Treatment: Case 1 1) Patient: Female adolescent
2) C.C.: Protrusive lips
3) Treatment: 1st premolar extraction
11. U44, L55 Extraction Treatment: Case 1 1) Patient: Female adult
2) C.C.: Protrusive lips and anterior crowding
3) Treatment: U44, L55 extraction
12. Bracket Positioning for U44, L55 Extraction Treatment 1) Bracket system for U44, L55 exraction
2) Common errors in accurate bracket placement for U44, L55 exraction
3) Problem solving
13. U55, L55 Extraction Treatment: Case 1 1) Patient: Female adult
2) C.C.: Protrusive lips and anterior crowding
3) Treatment: U55, L55 extraction
14. Only U44 Extraction Treatment: Case 1 1) Patient: Female adult
2) C.C.: Upper anterior teeth protrusion
3) Treatment: Only U44 extraction
15. Only U55 Extraction Treatment: Case 1 1) Patient: Female adult
2) C.C.: Protrusive lips
3) Treatment: Only U55 extraction
16. Malocclusion Treatment According to POP 1) Maintain vs change in POP
2) AB-maxillomandibular triangle and posterior occlusion
3) Molar forward movement
17. Noraml UOP and Normal POP: Extraction Treatment 1) Normal UOP and normal POP: Characteristics
2) Extraction in Class I normal UOP and POP
3) Extraction in Class II normal UOP and POP
4) Extraction in Class III normal UOP and POP
18. Noraml UOP and Steep POP: Extraction Treatment 1) Normal UOP and steep POP: Characteristics
2) Premolar extraction and occlusal plane change
3) Extraction in steep POP
19. Steep UOP and Steep POP: Extraction Treatment 1) Steep UOP: Characteristics
2) Upper incisor retraction with intrusion and root lingual torque
3) Premolar extraction in steep UOP
20. Asymmetric Premolar Extraction Treatment 1) Patient: Female adult
2) C.C.: Anterior crowding
3) Treatment: U54, L55 extraction
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