Skip to main content

Advertisement

SpringerLink
Log in

Pretreatment dentoskeletal comparison between individuals treated with extractions in the 1970s and in the new millennium

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objective

This retrospective study aimed to compare the occlusal and dentoskeletal initial features of patients treated with four first premolar extractions in the 1970s and after 2000.

Materials and methods

Group 70′ was composed by 30 subjects with Class I malocclusion (mean age of 12.8 years, 10 male, 20 female) treated in the 1970s with four first premolar extractions and comprehensive orthodontic treatment. Group NM comprised 30 subjects with Class I malocclusion (mean age of 13.4 years, 13 male, 17 female) treated in the new millennium, similarly to Group 70′. Initial dental models and lateral cephalograms were digitized and measured using OrthoAnalyzerTM 3D software and Dolphin Imaging 11.0 software, respectively. Initial occlusal and dentoskeletal features were analyzed and compared. Intergroup comparison was performed using t tests (p < 0.05). Holm-Bonferroni correction for multiple comparison was applied.

Results

Group NM showed significantly greater maxillary and mandibular effective lengths and greater maxillary and mandibular incisor protrusion in comparison with Group 70′. Group NM presented a significantly greater lower anterior facial height. Group NM also showed significantly smaller nasolabial angle and protruded inferior lip.

Conclusion

Patients with Class I malocclusion treated with four first premolar extractions in the new millennium present a greater degree of dental and labial protrusion, increased lower anterior facial height, and more acute nasolabial angle compared with patients treated similarly in the 1970s. Greater dental and labial protrusion determines first premolar extractions in the new millennium.

Clinical relevance

Despite the decrease of tooth extraction frequency, four first premolar extractions may be justified in cases with severe dental and skeletal protrusions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Tweed CH (1944) Indications for the extraction of teeth in orthodontic procedure. Am J Orthodont Oral Surg 30(8):405–428

    Article  Google Scholar 

  2. Tweed CH (1945) A philosophy of orthodontic treatment. Am J Orthodont Oral Surg 31(2):74–103

    Article  Google Scholar 

  3. Weintraub JA, Vig PS, Brown C, Kowalski CJ (1989) The prevalence of orthodontic extractions. Am J Orthodont Dentofac Orthop 96(6):462–466

    Article  Google Scholar 

  4. Lundström AF (1925) Malocclusion of the teeth regarded as a problem in connection with the apical base. Int J Orthodont Oral Surg Radiogr 11(12):1109–1133

    Article  Google Scholar 

  5. Angle EH (1907) Treatment of malocclusion of the teeth: Angle's system. White Dental Manufacturing Company

  6. Peck S (2017) Extractions, retention and stability: the search for orthodontic truth. Eur J Orthod 39(2):109–115. https://doi.org/10.1093/ejo/cjx004

    Article  PubMed  Google Scholar 

  7. Proffit WR (1994) Forty-year review of extraction frequencies at a university orthodontic clinic. Angle Orthodont 64(6):407–414. https://doi.org/10.1043/0003-3219(1994)064<0407:FROEFA>2.0.CO;2

    Article  PubMed  Google Scholar 

  8. Janson G, Maria FR, Bombonatti R (2014) Frequency evaluation of different extraction protocols in orthodontic treatment during 35 years. Prog Orthod 15:51. https://doi.org/10.1186/s40510-014-0051-z

    Article  PubMed  PubMed Central  Google Scholar 

  9. Jackson TH, Guez C, Lin FC, Proffit WR, Ko CC (2017) Extraction frequencies at a university orthodontic clinic in the 21st century: demographic and diagnostic factors affecting the likelihood of extraction. Am J Orthodont Dentofac Orthop 151(3):456–462. https://doi.org/10.1016/j.ajodo.2016.08.021

    Article  Google Scholar 

  10. Drobocky OB, Smith RJ (1989) Changes in facial profile during orthodontic treatment with extraction of four first premolars. Am J Orthodont Dentofac Orthop 95(3):220–230

    Article  Google Scholar 

  11. Bravo LA (1994) Soft tissue facial profile changes after orthodontic treatment with four premolars extracted. Angle Orthodont 64(1):31–42. https://doi.org/10.1043/0003-3219(1994)064<0031:STFPCA>2.0.CO;2

    Article  PubMed  Google Scholar 

  12. Holdaway RA (1983) A soft-tissue cephalometric analysis and its use in orthodontic treatment planning. Part I. Am J Orthodont 84(1):1–28

    Article  Google Scholar 

  13. Holdaway RA (1984) A soft-tissue cephalometric analysis and its use in orthodontic treatment planning. Part II. Am J Orthodont 85(4):279–293

    Article  Google Scholar 

  14. Peck H, Peck S (1970) A concept of facial esthetics. Angle Orthodont 40(4):284–318. https://doi.org/10.1043/0003-3219(1970)040<0284:ACOFE>2.0.CO;2

    Article  PubMed  Google Scholar 

  15. Auger TA, Turley PK (1999) The female soft tissue profile as presented in fashion magazines during the 1900s: a photographic analysis. Int J Adult Orthodont Orthogn Surg 14(1):7–18

    Google Scholar 

  16. Little RM (1990) Stability and relapse of dental arch alignment. Br J Orthod 17(3):235–241

    Article  Google Scholar 

  17. Little RM, Wallen TR, Riedel RA (1981) Stability and relapse of mandibular anterior alignment-first premolar extraction cases treated by traditional edgewise orthodontics. Am J Orthod 80(4):349–365

    Article  Google Scholar 

  18. Frankel R (1974) Decrowding during eruption under the screening influence of vestibular shields. Am J Orthod 65(4):372–406

    Article  Google Scholar 

  19. Haas AJ (1970) Palatal expansion: just the beginning of dentofacial orthopedics. Am J Orthod 57(3):219–255

    Article  Google Scholar 

  20. Cancado RH, Pinzan A, Janson G, Henriques JF, Neves LS, Canuto CE (2008) Occlusal outcomes and efficiency of 1- and 2-phase protocols in the treatment of class II division 1 malocclusion. Am J Orthodont Dentofac Orthop 133(2):245–253; quiz 328 e241-242. https://doi.org/10.1016/j.ajodo.2006.03.042

    Article  Google Scholar 

  21. O'Brien K, Wright J, Conboy F, Sanjie Y, Mandall N, Chadwick S, Connolly I, Cook P, Birnie D, Hammond M, Harradine N, Lewis D, McDade C, Mitchell L, Murray A, O'Neill J, Read M, Robinson S, Roberts-Harry D, Sandler J, Shaw I (2003) Effectiveness of early orthodontic treatment with the twin-block appliance: a multicenter, randomized, controlled trial. Part 1: dental and skeletal effects. Am J Orthodont Dentofac Orthop 124(3):234–243; quiz 339. https://doi.org/10.1016/S0889540603003524

    Article  Google Scholar 

  22. Sheridan JJ (1987) Air-rotor stripping update. J Clin Orthodont 21(11):781–788

    Google Scholar 

  23. Sheridan JJ, Hastings J (1992) Air-rotor stripping and lower incisor extraction treatment. J Clin Orthodont 26(1):18–22

    Google Scholar 

  24. Luecke PE 3rd, Johnston LE Jr (1992) The effect of maxillary first premolar extraction and incisor retraction on mandibular position: testing the central dogma of “functional orthodontics”. Am J Orthodont Dentofac Orthop 101(1):4–12. https://doi.org/10.1016/0889-5406(92)70075-L

    Article  Google Scholar 

  25. McLaughlin RP, Bennett JC (1995) The extraction-nonextraction dilemma as it relates to TMD. Angle Orthodont 65(3):175–186. https://doi.org/10.1043/0003-3219(1995)065<0175:TEDAIR>2.0.CO;2

    Article  PubMed  Google Scholar 

  26. Alexander RG, Sinclair PM, Goates LJ (1986) Differential diagnosis and treatment planning for the adult nonsurgical orthodontic patient. Am J Orthod 89(2):95–112

    Article  Google Scholar 

  27. Iared W, Koga da Silva EM, Iared W, Rufino Macedo C (2017) Esthetic perception of changes in facial profile resulting from orthodontic treatment with extraction of premolars: a systematic review. J Am Dent Assoc 148(1):9–16. https://doi.org/10.1016/j.adaj.2016.09.004

    Article  PubMed  Google Scholar 

  28. Garib DG, Bressane LB, Janson G, Gribel BF (2016) Stability of extraction space closure. Am J Orthodont Dentofac Orthop 149(1):24–30. https://doi.org/10.1016/j.ajodo.2015.06.019

    Article  Google Scholar 

  29. Sameshima GT, Sinclair PM (2001) Predicting and preventing root resorption: part II. Treatment factors. Am J Orthodont Dentofac Orthop 119(5):511–515. https://doi.org/10.1067/mod.2001.113410

    Article  Google Scholar 

  30. Konstantonis D, Anthopoulou C, Makou M (2013) Extraction decision and identification of treatment predictors in class I malocclusions. Prog Orthod 14:47. https://doi.org/10.1186/2196-1042-14-47

    Article  PubMed  PubMed Central  Google Scholar 

  31. Guirro WJ, Freitas KM, Janson G, de Freitas MR, Quaglio CL (2016) Maxillary anterior alignment stability in class I and class II malocclusions treated with or without extraction. Angle Orthodont 86(1):3–9. https://doi.org/10.2319/112614-847.1

    Article  PubMed  Google Scholar 

  32. Little RM (1975) The irregularity index: a quantitative score of mandibular anterior alignment. Am J Orthod 68(5):554–563

    Article  Google Scholar 

  33. Richmond S, Shaw WC, O'Brien KD, Buchanan IB, Jones R, Stephens CD, Roberts CT, Andrews M (1992) The development of the PAR index (peer assessment rating): reliability and validity. Eur J Orthod 14(2):125–139

    Article  Google Scholar 

  34. Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86(2):420–428. https://doi.org/10.1037//0033-2909.86.2.420

    Article  PubMed  Google Scholar 

  35. Dahlberg G (1949) Standard error and medicine. Acta Genet Stat Med 1(4):313–321

    PubMed  Google Scholar 

  36. Saleh WK, Ariffin E, Sherriff M, Bister D (2015) Accuracy and reproducibility of linear measurements of resin, plaster, digital and printed study-models. J Orthod 42(4):301–306. https://doi.org/10.1179/1465313315Y.0000000016

    Article  PubMed  Google Scholar 

  37. Farooq MU, Khan MA, Imran S, Sameera A, Qureshi A, Ahmed SA, Kumar S, Rahman MA (2016) Assessing the reliability of digitalized cephalometric analysis in comparison with manual cephalometric analysis. J Clin Diagn Res 10(10):ZC20–ZC23. https://doi.org/10.7860/JCDR/2016/17735.8636

    Article  PubMed  PubMed Central  Google Scholar 

  38. Mayers M, Firestone AR, Rashid R, Vig KW (2005) Comparison of peer assessment rating (PAR) index scores of plaster and computer-based digital models. Am J Orthodont Dentofac Orthop 128(4):431–434. https://doi.org/10.1016/j.ajodo.2004.04.035

    Article  Google Scholar 

  39. Zablocki HL, McNamara JA Jr, Franchi L, Baccetti T (2008) Effect of the transpalatal arch during extraction treatment. Am J Orthodont Dentofac Orthop 133(6):852–860. https://doi.org/10.1016/j.ajodo.2006.07.031

    Article  Google Scholar 

  40. Anthopoulou C, Konstantonis D, Makou M (2014) Treatment outcomes after extraction and nonextraction treatment evaluated with the American Board of Orthodontics objective grading system. Am J Orthodont Dentofac Orthop 146(6):717–723. https://doi.org/10.1016/j.ajodo.2014.07.025

    Article  Google Scholar 

  41. Freitas KM, Freitas DS, Valarelli FP, Freitas MR, Janson G (2008) PAR evaluation of treated class I extraction patients. Angle Orthodont 78(2):270–274. https://doi.org/10.2319/042307-206.1

    Article  PubMed  Google Scholar 

  42. Sayin MO, Turkkahraman H (2004) Malocclusion and crowding in an orthodontically referred Turkish population. Angle Orthodont 74(5):635–639. https://doi.org/10.1043/0003-3219(2004)074<0635:MACIAO>2.0.CO;2

    Article  PubMed  Google Scholar 

  43. Jung MH (2015) An evaluation of self-esteem and quality of life in orthodontic patients: effects of crowding and protrusion. Angle Orthodont 85(5):812–819. https://doi.org/10.2319/091814.1

    Article  PubMed  Google Scholar 

  44. Kamal AT, Shaikh A, Fida M (2016) Occlusal outcome of non-extraction and all first premolars extraction treatment in patients with class-I malocclusion. J Ayub Med Coll Abbottabad 28(4):664–668

    PubMed  Google Scholar 

  45. Bowman SJ, Johnston LE Jr (2000) The esthetic impact of extraction and nonextraction treatments on Caucasian patients. Angle Orthodont 70(1):3–10. https://doi.org/10.1043/0003-3219(2000)070<0003:TEIOEA>2.0.CO;2

    Article  PubMed  Google Scholar 

  46. Czarnecki ST, Nanda RS, Currier GF (1993) Perceptions of a balanced facial profile. Am J Orthodont Dentofac Orthop 104(2):180–187. https://doi.org/10.1016/S0889-5406(05)81008-X

    Article  Google Scholar 

  47. Mees S, Jimenez Bellinga R, Mommaerts MY, De Pauw GA (2013) Preferences of AP position of the straight Caucasian facial profile. J Craniomaxillofac Surg 41(8):755–763. https://doi.org/10.1016/j.jcms.2013.01.014

    Article  PubMed  Google Scholar 

  48. Moresca R (2014) Class I malocclusion with severe double protrusion treated with first premolars extraction. Dent Press J Orthodont 19(3):127–138

    Article  Google Scholar 

  49. Gollner N, Winkler J, Gollner P, Gkantidis N (2019) Effect of mandibular first molar mesialization on alveolar bone height: a split mouth study. Prog Orthod 20(1):22. https://doi.org/10.1186/s40510-019-0275-z

    Article  PubMed  PubMed Central  Google Scholar 

  50. Marusamy KO, Ramasamy S, Wali O (2018) Molar protraction using miniscrews (temporary anchorage device) with simultaneous correction of lateral crossbite: an orthodontic case report. J Int Soc Prevent Commun Dent 8(3):271–276. https://doi.org/10.4103/jispcd.JISPCD_447_17

    Article  Google Scholar 

  51. Beit P, Konstantonis D, Papagiannis A, Eliades T (2017) Vertical skeletal changes after extraction and non-extraction treatment in matched class I patients identified by a discriminant analysis: cephalometric appraisal and Procrustes superimposition. Prog Orthod 18(1):44. https://doi.org/10.1186/s40510-017-0198-5

    Article  PubMed  PubMed Central  Google Scholar 

  52. Bills DA, Handelman CS, BeGole EA (2005) Bimaxillary dentoalveolar protrusion: traits and orthodontic correction. Angle Orthodont 75(3):333–339. https://doi.org/10.1043/0003-3219(2005)75[333:BDPTAO]2.0.CO;2

    Article  PubMed  Google Scholar 

  53. Pearson LE (1978) Vertical control in treatment of patients having backward-rotational growth tendencies. Angle Orthodont 48(2):132–140. https://doi.org/10.1043/0003-3219(1978)048<0132:VCITOP>2.0.CO;2

    Article  PubMed  Google Scholar 

  54. Kocadereli I (1999) The effect of first premolar extraction on vertical dimension. Am J Orthodont Dentofac Orthop 116(1):41–45

    Article  Google Scholar 

  55. Kumari M, Fida M (2010) Vertical facial and dental arch dimensional changes in extraction vs. non-extraction orthodontic treatment. J Coll Phys Surg--Pakista 20(1):17–21. https://doi.org/10.2010/JCPSP.1721

    Article  Google Scholar 

  56. Sundareswaran S, Vijayan R (2017) Profile changes following orthodontic treatment of class I bimaxillary protrusion in adult patients of Dravidian ethnicity: a prospective study. Indian J Dent Res 28(5):530–537. https://doi.org/10.4103/ijdr.IJDR_549_15

    Article  PubMed  Google Scholar 

  57. Kirschneck C, Proff P, Reicheneder C, Lippold C (2016) Short-term effects of systematic premolar extraction on lip profile, vertical dimension and cephalometric parameters in borderline patients for extraction therapy--a retrospective cohort study. Clin Oral Investig 20(4):865–874. https://doi.org/10.1007/s00784-015-1574-5

    Article  PubMed  Google Scholar 

  58. Steiner CC (1960) The use of cephalometrics as an aid to planning and assessing orthodontic treatment: report of a case. Am J Orthod Dentofac Orthop 46(10):721–735

    Article  Google Scholar 

  59. Tweed CH (1946) The Frankfort-mandibular plane angle in orthodontic diagnosis, classification, treatment planning, and prognosis. Am J Orthodont Oral Surg 32(4):175–230

    Article  Google Scholar 

  60. Wahl N (2006) Orthodontics in 3 millennia. Chapter 8: the cephalometer takes its place in the orthodontic armamentarium. Am J Orthodont Dentofac Orthop 129(4):574–580. https://doi.org/10.1016/j.ajodo.2006.01.013

    Article  Google Scholar 

Download references

Acknowledgments

The authors would like to thank the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.

Funding

This study was financially supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - (CAPES) - Finance Code 001.

Author information

Authors and Affiliations

  1. Department of Orthodontics, Bauru Dental School, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP CODE 17012-901, Vila Nova Cidade Universitária, Bauru, São Paulo, Brazil

    Rodrigo Naveda, Guilherme Janson, Gabriela Manami Natsumeda & Marcos Roberto de Freitas

  2. Department of Orthodontics, Bauru dental School, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Rua Sílvio Marchione, 3-20, ZIP CODE 17012-900, Vila Nova Cidade Universitária, Bauru, São Paulo, Brazil

    Leopoldino Capelozza-Filho

  3. Department of Orthodontics, Bauru Dental School and Hospital for Rehabilitation of Dentofacial Anomalies, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP CODE 17012-901, Vila Nova Cidade Universitária, Bauru, São Paulo, Brazil

    Daniela Garib

Authors
  1. Rodrigo Naveda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guilherme Janson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gabriela Manami Natsumeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marcos Roberto de Freitas
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Leopoldino Capelozza-Filho
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Daniela Garib
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rodrigo Naveda.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

In this article, all procedures involving human participants were in accordance with the ethical standards of the Research Ethics Committee of Bauru Dental Scooll, University of São Paulo (#71638417.9.0000.5417).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is based on research submitted by Dr. Rodrigo Naveda in partial fulfillment of the requirements for the M.Sc. degree in Orthodontics at Bauru Dental School, University of São Paulo.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Naveda, R., Janson, G., Natsumeda, G.M. et al. Pretreatment dentoskeletal comparison between individuals treated with extractions in the 1970s and in the new millennium. Clin Oral Invest 25, 1997–2005 (2021). https://doi.org/10.1007/s00784-020-03508-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-020-03508-w

Keywords

Search

Navigation