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Here is the issue with tooth extraction ortho (whether it is 4 bi extraction or 2 bi extraction and or even incisor extraction of upper or lower arches).
When dental arches are orthodontically retracted posteriorly to close up dental spaces they actually are retracting and placing re-aligning teeth into the invaded much valued intra oral tongue volume space. What this can do is negatively impact natural/ physiologic maxillary cranial to physiologic neuromuscular mandibular positioning as well as negatively impact the buccinator mechanism function. Maxillary retraction orthodontics can negative effect how the mandibular jaw naturally wants to close but now has to posteriorize each time to accommodate the occluding and gearing of the retracted arch of teeth. Such arch retraction activates an unwanted anterior teeth avoidance contact response (mandible wants to close in the former more anterior position, but now has to retract posteriorly), thus causing the muscles to pull back and retract stimulating the unwanted muscle tensions and responses we all know as TMD. Mandible retracts back to avoid the premature contacting of anterior incisors (cuspid to cuspid region). Occluding the teeth in the unnatural (pathologic) position causing condyles to compress into the glenoid fossa resulting in anteriorly displaced disc and all the constellation of musculoskeletal occlusal strains, torques, skews and abnormal vector of forces…causing unwatned symptoms that are noted on this forum.
Not all bicuspid extraction ortho results in TMD problems. It is the retraction philosophy of orthodontics, the closing of the spaces and the invasion of the repositioning of the teeth (mainly the maxillary incisor region (back) to close the undesirable spaces (bicuspids) that creates the maxillary/cranial collapse and hyper muscle activity of TMD problems. It is the closing of the missing lower bicuspid spaces to make crowded teeth look straight but now are retracted into abnormal tongue space (narrowing arches and antero-posterior arch length) that causes the mandible to now close posterior of an optimized myo-trajectory, becoming less stable, stimulating abnormal muscle activity during opening and closing acts, producing reproducible engrammed pathologic muscle and occluding patterns to show up in a memorized way….to allow the day in and day out closing of the jaws to function to an abnormal terminal contact position, tongue now postures over the posterior occlusal surfaces of the impaired teeth. Muscles are now disabled / impaired/ dysfunctional and many things that are discussed on this forum are now exposed and questioned.
No physiologic rest for the muscles, no optimal mandibular closing path to optimally occlude the teeth to a true physiologic balance. joints sounds and clicks and or further joint derangement ensue, neck and head posture is compromised, airway breathing becomes an issue, etc etc…and the orthodontists blames the patient for not wearing their retainers. WHY?
If you don’t wear ortho retainers after the brackets and wires come off after all that teeth alignment treatment was applied classically (whether invisalign, clear aligners or fixed wire bracket orthodontic methods/technique is conveniently marketed and or dangled in front of everyone’s eyes as the coolest and newest methods…what happens to the teeth after everything is removed? You all will realize the answer.
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Leader in Gneuromuscular and Neuromuscular Dentistry