What is the extraction sequence in serial extraction for severe crowding in mixed dentition?

What is the extraction sequence in serial extraction for severe crowding in mixed dentition?

• A. Primary canines → Primary 1st molars → Permanent 1st premolars
• B. Primary canines → Primary 2nd molars → Permanent 1st premolars
• C. Primary canines → Primary 1st molars → Permanent 2nd premolars
• D. Primary canines → Primary 2nd molars → Permanent 2nd premolars

Answer: (A)

Serial extraction uses staged tooth removals to guide eruption and create space as the dentition develops. The first step is removing deciduous canines. This opens space in the front, allowing the permanent incisors to erupt into better alignment and reducing anterior crowding without destabilizing the molar relationship. The next step is extracting the deciduous first molars. This creates room for the eruption of the permanent first premolars, helping to balance the arch length as growth continues and preserving space for the future premolar eruption. The final step is removing the permanent first premolars. This provides substantial space to accommodate the eruption and alignment of remaining teeth, including canines and posterior teeth, and helps establish proper occlusion with favorable cusp guidance. Using this sequence—deciduous canines, then deciduous first molars, then permanent first premolars—fits the goal of serial extraction: relieve crowding progressively by leveraging natural eruption patterns rather than heading straight to extensive fixed appliances.

Serial extraction uses staged tooth removals to guide eruption and create space as the dentition develops. The first step is removing deciduous canines. This opens space in the front, allowing the permanent incisors to erupt into better alignment and reducing anterior crowding without destabilizing the molar relationship.

The next step is extracting the deciduous first molars. This creates room for the eruption of the permanent first premolars, helping to balance the arch length as growth continues and preserving space for the future premolar eruption.

The final step is removing the permanent first premolars. This provides substantial space to accommodate the eruption and alignment of remaining teeth, including canines and posterior teeth, and helps establish proper occlusion with favorable cusp guidance.

Using this sequence—deciduous canines, then deciduous first molars, then permanent first premolars—fits the goal of serial extraction: relieve crowding progressively by leveraging natural eruption patterns rather than heading straight to extensive fixed appliances.