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Right Ortho - Orthodontic Training
Drs. Andrey & Sergey Tikhonovs
-оrthodontists, teachers, brothers We are twin brothers - Andrey and Sergey.

We have been training young orthodontists for over 10 years to improve their orthodontic skills ranging from diagnosis and treatment planning to clinical technique. We know we can provide useful, practical, and most importantly evidence-based information for contemporary orthodontic treatment. This project is oriented for any orthodontist who wants to become more efficient in their clinical practice while achieving high-quality outcomes.

15/10/2026

Before I commit to an extraction plan, I want to be able to explain how the spaces will be closed.

Which part will be closed by the anterior teeth? Which part by the posterior teeth? How does that distribution fit the starting occlusion and the planned final relationship?

These are the questions behind the Class II example in this series. Naming the teeth to be extracted does not answer them.

In the OrthoPlanner online school, we teach a step-by-step approach to orthodontic treatment planning. We calculate anterior and posterior space closure in both arches and use those calculations to assess whether extractions are justified.

The aim is a plan that specifies the required movements in millimeters before treatment begins.

Study the planning process behind the decision, rather than relying on a remembered extraction pattern.

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15/10/2026

An extraction plan should specify anterior and posterior space closure in both arches.

Our simplified Class II geometric model makes the relationship visible: Z = Y + X.

X is the difference from a Class I first-molar relationship. Y is the planned posterior anchorage loss. Z is the lower first-molar mesialization required to reach Class I in the model.

The model then estimates the lower extraction space available for alignment as 7 − Z mm. It is presented for planning without growth, mandibular advancement or orthognathic surgery.

The purpose is to see how much space remains useful for the lower space deficiency after accounting for the required posterior movement.

In the OrthoPlanner online school, we work through a step-by-step planning approach to calculating space closure and assessing the extraction decision.

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15/10/2026

A simplified rule can help flag a questionable extraction decision.

It still does not tell me every movement the patient needs.
For the non-growing Class II patient treated without orthognathic surgery, our usual lower-extraction rule uses the molar relationship as a starting point.

The complete plan must go further: how many millimeters will the anterior teeth close, and how many will the posterior teeth close, in each arch?

Those numbers need to account for both the existing occlusion and the intended final relationship. Remembering a rule and applying a planning algorithm are different levels of detail.

In the OrthoPlanner online school, we teach the step-by-step process behind these calculations. The goal is to move from “this extraction pattern seems reasonable” to an explanation of the movements it requires.

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15/10/2026

The calculation may show that only 2 mm or less of the lower extraction space can be used to resolve crowding.

This is an illustrative example from the Class II scenario discussed in the post — not a universal extraction threshold.

The remaining space would need to be closed by moving the posterior teeth forward. At that point, I would reconsider the usefulness of the lower extraction and evaluate alternatives, including distalization in a suitable case.

The important step is doing the calculation before extracting, rather than discovering the distribution of space during treatment.
To reach that decision, I need the current posterior relationship, the space deficiency and the planned final occlusion.

In the OrthoPlanner online school, we work through a structured planning algorithm to calculate anterior and posterior space closure in both arches.

Comment DETAILS for the OrthoPlanner program and registration details.

15/10/2026

After choosing upper and lower premolar extractions in a Class II case, how do you plan to achieve a Class I canine relationship?

For the non-growing, non-surgical patient discussed here, this question needs an answer before treatment starts.

In my clinical teaching, I encounter plans that specify which teeth will be extracted but do not calculate how the remaining teeth will move. The difficulty may then appear later: the canine relationship is not the one intended, or the lower posterior teeth require prolonged mesialization.

Class II elastics, correctors or miniscrew anchorage may be needed. The original planning question still remains: how much movement was required, and was it accounted for?

The OrthoPlanner online school focuses on calculating the movements needed to connect the initial occlusion with the planned finish.

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15/10/2026

Creating extraction space and having space available for alignment are not the same calculation.

In our geometric model for a non-growing Class II patient, part of the lower extraction space must be closed by moving the posterior teeth mesially to reach the planned relationship.

That part cannot also be counted as space available to resolve lower crowding.
This is why an extraction decision can look reasonable when I consider only the space deficiency, yet become less useful after calculating the required movements.

Before treatment, I need to know how much space the anterior teeth will close and how much the posterior teeth will close. Otherwise, I am leaving a substantial part of the plan unresolved.

In the OrthoPlanner online school, we calculate this distribution step by step, using the starting occlusion and the planned final relationship.

Comment DETAILS for the OrthoPlanner program and registration details.

15/10/2026

For a non-growing Class II patient treated with extractions and without orthognathic surgery, we use a simplified geometric rule.

We usually avoid lower-arch extractions when the molar relationship is beyond half-cusp Class II — more than 3.5 mm.

Why? In the scenario described, much of the lower extraction space would need to be closed by moving the posterior teeth forward, rather than being available to resolve crowding. This can become a difficult, time-consuming part of treatment.

The rule is a useful starting point. It is not a substitute for calculating the anterior and posterior contribution to space closure in the individual plan.

In the OrthoPlanner online school, we go beyond remembering the threshold and work through the calculations that help assess whether extractions are justified.

Comment DETAILS for the OrthoPlanner program and registration details.

15/10/2026

Crowding tells me how much space is missing.

It does not, by itself, tell me whether lower-arch extractions are justified.

In a non-growing Class II patient treated without orthognathic surgery, I also need to account for the current posterior relationship and the Class I canine relationship I am planning to achieve.

Only then can I calculate how much extraction space is available for alignment and how much must be closed by mesializing the lower posterior teeth.

The frequent planning error is not simply choosing extractions. It is choosing them without calculating that distribution.

Before accepting a plan, I want to see the starting relationship, the intended final relationship and the movements connecting the two.

The OrthoPlanner online school teaches a step-by-step approach to connecting these elements and calculating space closure in millimeters.

Comment DETAILS for the OrthoPlanner program and registration details.

15/10/2026

Before a lower premolar extraction, I want to know where the resulting space will go.

For the non-growing, non-surgical Class II patient discussed here, there are two separate calculations: how much space can be used to resolve lower-arch crowding, and how much must be closed by moving the posterior teeth forward.

It is easy to focus on the visible space deficiency and overlook the second part. But the existing posterior relationship and the planned final occlusion determine the movements that will be needed.

A plan should therefore specify the contribution of the anterior and posterior teeth in millimeters. “We will close the spaces” is not specific enough.

This is the type of planning we teach in the OrthoPlanner online school: breaking an extraction decision down into calculated movements in both arches.

Comment DETAILS for the OrthoPlanner program and registration details.

15/10/2026

“Four premolar extractions” describes a decision.

It does not tell me how the spaces will be closed.

A non-growing Class II patient may have crowding in both arches. Before choosing upper and lower extractions, I need to calculate how many millimeters will be closed by the anterior teeth and how many by the posterior teeth.

That calculation must include the existing posterior relationship and the planned Class I canine finish. Measuring crowding alone does not answer the question.

Without this step, I may create a lower extraction space that contributes little to alignment but requires substantial forward movement of the posterior teeth.
In the OrthoPlanner online school, we work through a step-by-step approach to these calculations. The aim is to explain the planned movements before committing to extractions.

Comment DETAILS for the OrthoPlanner program and registration details.

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