Dr. Fred Schudy: The Removal of Enamel to Relieve Crowding

In the November 2000 issue of the AJODO, the editor published an editorial in which he discussed distraction of the symphysis to relieve crowding of the incisors.

He states that, "When there is excessive tooth mass, extraction or stripping is the correct treatment. However, when a transverse (skeletal) discrepancy exists, space can be gained through distraction." Since the subject of the editorial was "Invited commentaries add value to topics," I took this to mean that the entire membership was invited to comment.

Our profession as a whole is cautious about "stripping" (reduction of enamel to provide room to eliminate crowding), and very few orthodontists have had the opportunity of observing the effects of "stripping" over a long period of time.

When my daughter was 13 years of age I removed more enamel from her upper incisors than I have ever removed from any other patient’s teeth. Now at age 62, while her molars and bicuspids are full of restorations, there never has been any caries in her incisors. I have never hesitated to remove enamel when it was desirable – often removing enamel to produce good cuspid interdigitation. My son, Dr. George Schudy, does not hesitate to remove enamel to accomplish a purpose.

I can honestly say that I have never seen caries as a result of enamel removal. So, that is my 50 year experience with enamel removal. Those who believe it will be greatly rewarded.

It is my opinion that distraction alone may not be sufficient to solve the problem of crowding. It may be necessary, in addition, to remove some enamel from the teeth. This was written with but one thought in mind – that is to share my experience with my highly respected colleagues.

The Removal of Enamel to provide Space to Relieve Crowding

The Removal of Enamel to provide Space
to Relieve Crowding