Effects of premolar extraction and orthodontic treatment in adolescents - a retrospective cephalometric study

Authors

  • Maria Ekstam Department of Oral and Maxillofacial Radiology, Malmö University, Malmö, Sweden
  • Mikael Sonesson Department of Orthodontics, Malmö University, Malmö, Sweden
  • Kristina Hellén-Halme Department of Oral and Maxillofacial Radiology, Malmö University, Malmö, Sweden

DOI:

https://doi.org/10.1080/00016357.2023.2267145

Keywords:

Cephalometry, extraction treatment, external apical root resorption, malocclusion, orthodontics

Abstract

Objectives: To evaluate the cephalometric effects of premolar extraction on skeletal and dental parameters, and on the soft tissues, in patients subsequently treated with fixed appliances. Prevalence and severity of external apical root resorption due to premolar extraction were also examined.

Materials and methods: The dental records of 79 patients treated with fixed appliances were retrieved (groups: extraction, n = 19; non-extraction, n = 60). Pre- and post-treatment statuses of skeletal, dentoalveolar, and soft tissue variables were analyzed on lateral cephalograms to determine change. Periapical radiographs of the maxillary incisors were assessed for external apical root resorption using the Levander & Malmgren index. The t-test, Mann-Whitney U test, chi-squared test, and Kruskal-Wallis test were used to analyze the data. Significance was set at p < .05.

Results: Changes in the protrusion and proclination of the incisors and in lip position were significantly different between the groups. Prevalence of external apical root resorption in the two groups was similar.

Conclusions: Our findings suggest that extraction therapy affects dentoalveolar traits but not jaw position, nor the risk of root resorption, in patients treated with fixed appliances 

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References

Dimberg L, Lennartsson B, Arnrup K, et al. Prevalence and change of malocclusions from primary to early permanent dentition: a longitudinal study. Angle Orthod. 2015;85(5):728-734. PubMed PMID: 25867255; PubMed Central PMCID:PMC8610411. doi: 10.2319/080414-542.1. https://doi.org/10.2319/080414-542.1

Cenzato N, Nobili A, Maspero C. Prevalence of dental malocclusions in different geographical areas: scoping review. Dent J.2021;9(10):117. Epub 20211011. PubMed PMID: 34677179; PubMedCentral PMCID: PMC8534899. doi: 10.3390/dj9100117. https://doi.org/10.3390/dj9100117

Dardengo CdS, Fernandes LQP, Capelli Júnior J. Frequency of orthodontic extraction. Dental Press J Orthod. 2016;21(1):54-59. PubMed PMID: 27007762; PubMed Central PMCID: PMC4816586.doi: 10.1590/2177-6709.21.1.054-059.oar. https://doi.org/10.1590/2177-6709.21.1.054-059.oar

Ciger S, Aksu M, Germeç D. Evaluation of posttreatment changes in class II division 1 patients after nonextraction orthodontic treatment: cephalometric and model analysis. Am J Orthod Dentofacial Orthop. 2005;127(2):219-223. doi: 10.1016/j.ajodo.2004.08.015. https://doi.org/10.1016/j.ajodo.2004.08.015

Phan XL, Schneider BJ, Sadowsky C, et al. Effects of orthodontic treatment on mandibular rotation and displacement in angle class II division 1 malocclusions. Angle Orthod. 2004;74(2):174-183. doi:10.1043/0003-3219(2004)074 < 0174:.eootom>2.0.Co;2.

Marques LS, Ramos-Jorge ML, Araujo MT, et al. Class II division 1 malocclusion with severe overbite: cephalometric evaluation of the effects of orthodontic treatment. World J Orthod. 2008;9(4):319-328.

Ishaq RA, AlHammadi MS, Fayed MM, et al. Fixed functional appliances with multibracket appliances have no skeletal effect on the mandible: a systematic review and meta-analysis. Am J Orthod Dentofacial Orthop. 2016;149(5):612-624. doi: 10.1016/j.ajodo.2015.11.023. https://doi.org/10.1016/j.ajodo.2015.11.023

Pearson LE. Vertical control in treatment of patients having backward-rotational growth tendencies. Angle Orthod. 1978;48(2):132-140. doi: 10.1043/0003-3219(1978)048 < 0132:.vcitop>2.0.Co;2.

Kocadereli I. The effect of first premolar extraction on vertical dimension. Am J Orthod Dentofacial Orthop. 1999;116(1):41-45. doi:10.1016/s0889-5406(99)70301-x. https://doi.org/10.1016/S0889-5406(99)70301-X

Türköz Ç, İşcan HN. Evaluation of extraction and non-extraction treatment effects by two different superimposition methods. Eur J Orthod. 2011;33(6):691-699. Epub 20110304. doi: 10.1093/ejo/cjq143. https://doi.org/10.1093/ejo/cjq143

Hayasaki SM, Castanha Henriques JF, Janson G, et al. Influence of extraction and nonextraction orthodontic treatment in Japanese-Brazilians with class I and class II division 1 malocclusions. Am J Orthod Dentofacial Orthop. 2005;127(1):30-36. doi:10.1016/j.ajodo.2003.10.043. https://doi.org/10.1016/j.ajodo.2003.10.043

Zafarmand AH, Zafarmand MM. Premolar extraction in orthodontics: does it have any effect on patient's facial height? J Int Soc Prev Community Dent. 2015;5(1):64-68. PubMed PMID: 25767770;PubMed Central PMCID: PMC4355853. doi: 10.4103/2231-0762.151980. https://doi.org/10.4103/2231-0762.151980

Gkantidis N, Halazonetis DJ, Alexandropoulos E, et al. Treatment strategies for patients with hyperdivergent class II division 1 malocclusion: is vertical dimension affected? Am J Orthod Dentofacial Orthop. 2011;140(3):346-355. doi: 10.1016/j.ajodo.2011.05.015. https://doi.org/10.1016/j.ajodo.2011.05.015

Klapper L, Navarro SF, Bowman D, et al. The influence of extraction and nonextraction orthodontic treatment on brachyfacial and dolichofacial growth patterns. Am J Orthod Dentofacial Orthop.1992;101(5):425-430. doi: 10.1016/0889-5406(92)70116-R. https://doi.org/10.1016/0889-5406(92)70116-R

Chua AL, Lim JY, Lubit EC. The effects of extraction versus nonextraction orthodontic treatment on the growth of the lower anterior face height. Am J Orthod Dentofacial Orthop. 1993;104(4):361-368.doi: 10.1016/S0889-5406(05)81334-4. https://doi.org/10.1016/S0889-5406(05)81334-4

Tieu LD, Saltaji H, Normando D, et al. Radiologically determined orthodontically induced external apical root resorption in incisors after non-surgical orthodontic treatment of class II division 1 malocclusion: a systematic review. Prog Orthod. 2014;15(1):48. (Epub 2014-07-23. doi: 10.1186/s40510-014-0048-7. https://doi.org/10.1186/s40510-014-0048-7

Lund H, Gröndahl K, Hansen K, et al. Apical root resorption during orthodontic treatment: a prospective study using cone beam CT. Angle Orthod. 2012;82(3):480-487. doi: 10.2319/061311-390.1. https://doi.org/10.2319/061311-390.1

Levander E, Malmgren O. Evaluation of the risk of root resorption during orthodontic treatment: a study of upper incisors. Eur J Orthod. 1988;10(1):30-38. doi: 10.1093/ejo/10.1.30. https://doi.org/10.1093/ejo/10.1.30

Handem RH, Janson G, Matias M, et al. External root resorption with the self-ligating damon system-a retrospective study. Prog Orthod. 2016;17(1):20. Epub 20160701. PubMed PMID: 27365168;PubMed Central PMCID: PMC4929110. doi: 10.1186/s40510-016-0133-1. https://doi.org/10.1186/s40510-016-0133-1

Mirabella AD, Artun J. Risk factors for apical root resorption of maxillary anterior teeth in adult orthodontic patients. Am J Orthod Dentofacial Orthop. 1995;108(1):48-55. doi: 10.1016/s0889-5406(95)70065-x. https://doi.org/10.1016/S0889-5406(95)70065-X

Maués CPR, do Nascimento RR, Vilella OdV Severe root resorption resulting from orthodontic treatment: prevalence and risk factors. Dental Press J Orthod. 2015;20(1):52-58. PubMed PMID: 25741825; PubMedCentral PMCID: PMC4373016. doi: 10.1590/2176-9451.20.1.052-058.oar. https://doi.org/10.1590/2176-9451.20.1.052-058.oar

Sameshima GT, Sinclair PM. Predicting and preventing root resorption: part I. Diagnostic factors. Am J Orthod Dentofacial Orthop.2001;119(5):505-510. doi: 10.1067/mod.2001.113409. https://doi.org/10.1067/mod.2001.113409

McFadden WM, Engstrom C, Engstrom H, et al. A study of the relationship between incisor intrusion and root shortening. Am J Orthod Dentofacial Orthop. 1989;96(5):390-396. doi: 10.1016/0889-5406(89)90323-5. https://doi.org/10.1016/0889-5406(89)90323-5

Taner T, Ciğer S, Sençift Y. Evaluation of apical root resorption following extraction therapy in subjects with class I and class II malocclusions. Eur J Orthod. 1999;21(5):491-496. doi: 10.1093/ejo/21.5.491. https://doi.org/10.1093/ejo/21.5.491

Segal GR, Schiffman PH, Tuncay OC. Meta analysis of the treatment-related factors of external apical root resorption. Orthod Craniofac Res.2004;7(2):71-78. doi: 10.1111/j.1601-6343.2004.00286.x. https://doi.org/10.1111/j.1601-6343.2004.00286.x

Weltman B, Vig KWL, Fields HW, et al. Root resorption associated with orthodontic tooth movement: a systematic review. Am J Orthod Dentofacial Orthop. 2010;137(4):462-476; discussion 12A.doi: 10.1016/j.ajodo.2009.06.021. https://doi.org/10.1016/j.ajodo.2009.06.021

Sondeijker CFW, Lamberts AA, Beckmann SH, et al. Development of a clinical practice guideline for orthodontically induced external apical root resorption. Eur J Orthod. 2020;42(2):115-124. PubMedPMID: 31087032; PubMed Central PMCID: PMC7109605. doi: 10.1093/ejo/cjz034. https://doi.org/10.1093/ejo/cjz034

Brezniak N, Wasserstein A. Root resorption after orthodontic treatment: part 2. Literature review. Am J Orthod Dentofacial Orthop.1993;103(2):138-146. doi: 10.1016/s0889-5406(05)81763-9. https://doi.org/10.1016/S0889-5406(05)81763-9

Mohandesan H, Ravanmehr H, Valaei N. A radiographic analysis of external apical root resorption of maxillary incisors during active orthodontic treatment. Eur J Orthod. 2007;29(2):134-139. Epub20070117. doi: 10.1093/ejo/cjl090. https://doi.org/10.1093/ejo/cjl090

Aliaga-Del Castillo A, Silva AOD, Maranhão OBV, et al. Root resorption in class II malocclusion treatment with and without maxillary premolar extractions. Am J Orthod Dentofacial Orthop. 2023;163(3):389-397.Epub 20221204. doi: 10.1016/j.ajodo.2021.12.024. https://doi.org/10.1016/j.ajodo.2021.12.024

Kang HK, Guo J, Kaczynski R, et al. Effects of maxillary incisor inclination on dentoalveolar changes in class II division 1 and 2 non-extraction treatment for Caucasian children - A retrospective study using CBCT. Int Orthod. 2021;19(1):51-59. Epub 20201210.doi: 10.1016/j.ortho.2020.11.003. https://doi.org/10.1016/j.ortho.2020.11.003

Malmgren O, Goldson L, Hill C, et al. Root resorption after orthodontic treatment of traumatized teeth. Am J Orthod. 1982;82(6):487-491.doi: 10.1016/0002-9416(82)90317-7. https://doi.org/10.1016/0002-9416(82)90317-7

Maaz M, Fida M. Dental, skeletal, and soft-tissue changes in adult orthodontic patients treated with premolar extraction and nonextraction: a cross-sectional study. Am J Orthod Dentofacial Orthop.2022;162(3):360-366. Epub 20220512. doi: 10.1016/j.ajodo.2021.04.026. https://doi.org/10.1016/j.ajodo.2021.04.026

Janson G, Mendes LM, Junqueira CH, et al. Soft-tissue changes in class II malocclusion patients treated with extractions: a systematic review. Eur J Orthod. 2016;38(6):631-637. Epub 20151129. doi:10.1093/ejo/cjv083. https://doi.org/10.1093/ejo/cjv083

Weyrich C, Lisson JA. The effect of premolar extractions on incisor position and soft tissue profile in patients with class II, division 1 malocclusion. J Orofac Orthop. 2009;70(2):128-138. Epub 20090326.doi: 10.1007/s00056-009-0813-2. https://doi.org/10.1007/s00056-009-0813-2

Basciftci FA, Usumez S. Effects of extraction and nonextraction treatment on class I and class II subjects. Angle Orthod.2003;73(1):36-42. doi: 10.1043/0003-3219(2003)073 < 0036:Eoeant>2.0.Co;2.

Bishara SE, Jakobsen JR, Hession TJ, et al. Soft tissue profile changes from 5 to 45 years of age. Am J Orthod Dentofacial Orthop.1998;114(6):698-706. doi: 10.1016/S0889-5406(98)70203-3. https://doi.org/10.1016/S0889-5406(98)70203-3

Paquette DE, Beattie JR, Johnston LE. A long-term comparison of nonextraction and premolar extraction edgewise therapy in "borderline" class II patients. Am J Orthod Dentofacial Orthop.1992;102(1):1-14. doi: 10.1016/0889-5406(92)70009-Y. https://doi.org/10.1016/0889-5406(92)70009-Y

Kocadereli I. Changes in soft tissue profile after orthodontic treatment with and without extractions. Am J Orthod Dentofacial Orthop. 2002;122(1):67-72. doi: 10.1067/mod.2002.125235. https://doi.org/10.1067/mod.2002.125235

Bayirli B, Vaden JL, Johnston LE.Jr. Long-term mandibular skeletal and dental effects of standard edgewise treatment. Am J Orthod Dentofacial Orthop. 2013;144(5):682-690. doi: 10.1016/j.ajodo.2013.07.008. https://doi.org/10.1016/j.ajodo.2013.07.008

Björk A, Skieller V. Normal and abnormal growth of the mandible. A synthesis of longitudinal cephalometric implant studies over a period of 25 years. Eur J Orthod. 1983;5(1):1-46. doi: 10.1093/ejo/5.1.1. https://doi.org/10.1093/ejo/5.1.1

Smale I, Artun J, Behbehani F, et al. Apical root resorption 6months after initiation of fixed orthodontic appliance therapy. Am J Orthod Dentofacial Orthop. 2005;128(1):57-67. doi: 10.1016/j.ajodo.2003.12.030. https://doi.org/10.1016/j.ajodo.2003.12.030

Artun J, Van 't Hullenaar R, Doppel D, et al. Identification of orthodontic patients at risk of severe apical root resorption. Am J Orthod Dentofacial Orthop. 2009;135(4):448-455. doi: 10.1016/j.ajodo.2007.06.012. https://doi.org/10.1016/j.ajodo.2007.06.012

de Freitas MR, Beltrão RT, Janson G, et al. Evaluation of root resorption after open bite treatment with and without extractions. Am J Orthod Dentofacial Orthop. 2007;132(2):143.e15-22-143.e22.doi: 10.1016/j.ajodo.2006.10.018. https://doi.org/10.1016/j.ajodo.2006.10.018

Parker RJ, Harris EF. Directions of orthodontic tooth movements associated with external apical root resorption of the maxillary central incisor. Am J Orthod Dentofacial Orthop. 1998;114(6):677-683.doi: 10.1016/s0889-5406(98)70200-8. https://doi.org/10.1016/S0889-5406(98)70200-8

Swedish_Radiation_Safety_Authority. Andreas von Schmalensee, Director of Communication; 2017.Available from: https://www.stralsakerhetsmyndigheten.se/en/:

Published

2024-03-26