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Indications for first permanent molar extraction pg 284

Long term prognosis poor
Increasing Caries or hypoplasia
Indications for early FPM extraction


Factors that favor FPM extraction:

Class I Occlusion Premolar crowding
No missing permanent teeth
FPMs with poor treatment prognosis
Dental age of 9-11

Timings for extraction

Acc to welbury 8.5 to 9.5 yrs
General recommendations (pres)
FPM should be extracted before eruption of the SPM
Lower FPM : When there is radiographic evidence of dentine calcification in the
lower SPM bifurcation This is usually at 8-10 years of age (mid mixdentition)
Upper FPM As long as the upper FPM is extracted before the upper SPM has
erupted (i.e. by 12-13 years of age), the SPM will tend to move into a favorable
occlusal position

Indications for contralateral/balancing extraction

Pg 607 carenza


Pg 95 96 welbury

Carenza pg 153 153 154

Functional Cusp: working cusp, supporting cusp, centric cusp B cusp of the mand
post teeth & Li cusps of the max post teeth --> occlude with the opposing central
fossa --> broad and rounded --> located approx 1/3 of buccolingual width of the
Non Functional Cusp: non working cusp, guilding cusp, noncentric cusp B cusp of
max post teeth & Li cusp of mand post teeth --> Relatively sharp with definite tips
--> located approx 1/6 of buccolingual width of the tooth

What are the five common characteristics of supporting cusps?

1. Contact opposing tooth in ICP
2. Support vertical dimension
3. Nearer faciolingual center than non
4. outer incline has potential for contact
5. Broader, rounded cusps

What are the supporting cusps?

Max. lingual and Mand. buccal cusps.

These cusps do grinding work because they occlude in a fossa or

marginal ridge. Also sometimes called _____ _____ because they
hold the occlusion in a middle position.
Supporting/Working Cusps
Centric Cusps

What are the non-supporting cusps?

Max. buccal and mand. lingual cusps

These cusps do not occlude or fit into fossae of marginal ridge

areas. These cusps allow the dentition to move apart, out of

occlusion. They allow the teeth to unlock and move back and
forth and side to side
non-supporting, balancing or non-centric cusps
Article color dimensions
..\..\Downloads\Documents\color dimension composite.pdf

All patients that are due to be prescribed bisphosphonates should have a dental
examination and have completed any dental treatment 2 weeks PRIOR to starting
bisphosphonates. All prescribing clinicians should ensure that patients are
signposted to visit a dentist before treatment is commenced.