Can RCT-failed molars be extracted instead of premolars for my orthodontic treatment?

Hi,

Welcome to icliniq.com.

I understand your concern. There are cases wherein the orthodontist has to change the general extraction protocol of four premolars and go for molars or incisors at times. But that is fine as long as we maintain the rest of the teeth healthy with good oral hygiene and esthetics. In your case (as you mentioned), root canal treatment for molars has failed. In such cases, it would be impossible to save the tooth from pain and further decay, and the next option is extraction. This is more favorable than removing a healthy premolar as in that case. You would lose a healthy tooth and have to go for a prosthesis for the molars. Hence, going for molar extraction is not an issue as long as it is the last option and cannot be saved. Do not worry. The gap caused by molar extraction will also close, similar to premolar extraction cases. It might require about two to three extra appointments as the molars are slightly wider than premolars. There will be some amount of facial profile change as the teeth shift. The upper lips and nose take indirect support from the underlying dentition. When you get a molar extracted, and the rest of the teeth move back to close the space, the immediate support to the lip is gone, and they also fall back. You would have some amount of proclination of your teeth, crowding, or both; that is why an extraction plan is suggested. Please share your side profile picture and a wide smiling photo (teeth visibility should be there). I can give you a rough estimate of how much your face will change. Kindly revert for more queries. Thank you.