Which Kind of Extractions Are Best for Bi-maxillary Protrusion?

My question is what is the difference between extracting first and second bicuspids for bi-maxillary protrusion? I saw two videos showing examples of the two types of extractions and it seems that with first bicuspid extractions, the lip retraction is more greater. I also noticed with second bicuspid extractions, the back teeth moves forward along with the front and thus less lip retraction. Is this right? Which one provides better profile ( I have a very full profile) results?

Doctor Answers 2

Bicuspid Extractions for Orthodontics

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Unless your facial profile is very full, I would recommend against having bicuspids removed - get another opinion.  Removing the bicuspids and pulling the teeth back to close the spaces can lead to TMJ issues and more importantly sleep breathing disorders like Sleep Apnea because there is not enough room for the tongue. 

Having said that, the deciding factor is usually how much space is needed, as the second bicuspids are slightly wider than the first bicuspids.

Ontario Dentist

Bi-Maxillary Protrusion and Extractions

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Try to find an orthodontist that can treat your mouth without ANY bicuspid extractions! I have seen too many people suffer later on with TMJ, Sleep Apnea (snoring), and other airway problems, all due to a narrowing of their dental arch as a result of bicuspid extractions by orthodontist. If there is any alternative to extracting the bicuspids, go for it!

Jay Neuhaus, DDS
New York Dentist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.