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PubMed2000

Johnston analysis evaluation of Class II correction in patients belonging to Petrovic growth categories 3 and 5.

Petrovic and Lavergne have proposed a classification of facial growth, consisting of 6 growth categories, according to which patients belonging to growth category 5 at the beginning are supposed to have greater mandibular growth during treatment than patients belonging to growth category 3. We tested this hypothesis with 2 groups of Class II patients: 25 from growth category 3 and 25 from category 5. Both groups consisted of males and females and had starting ages that ranged from 10 to 15 years. Treatment was carried out with a nonangulated edgewise appliance in conjunction with the extraction of four first premolars. The Johnston "Pitchfork" analysis was used to assess treatment changes. It showed that the molar correction was almost identical in amount in growth categories 3 and 5. Its source, however, was not. Differential jaw growth (ABCH) accounted for 75% of molar correction in category 3, but 107. 5% in category 5. On average, there was 1.9 mm of extra mandibular advancement relative to cranial base in category 5 as compared with that of category 3. Mandibular advancement was the most important single factor for the molar and overjet corrections in both groups. Treatment success, evaluated according to Lavergne's treatment objectives, showed that edgewise extraction therapy with headgear is more suitable to patients in category 3 than to the ones in category 5. Further research should explore the treatment methods and goals appropriate to these two growth categories.

Adolescent↗

PubMed1993

Case report BC: extraction decisions based on treatment responses.

We have all been into treatment and lost sight of the "plan" we were so familiar with at the treatment planning stage. Eighteen to 21 months into treatment, we are faced with extraction decisions or surgical planning that should have been addressed at 9 or 12 months. This case report illustrates a treatment plan with several variables that were dependent upon treatment responses. It also illustrates planning a gingival graft to increase the crown length of a first premolar after the canine was substituted as the lateral incisor.

Adolescent↗

PubMed1986

Second molar extractions: a review.

In this exhaustive review, a number of parameters related to maxillary and mandibular second molar extractions are discussed. The parameters reviewed include the timing of extractions and the effect of extractions on third molar eruption, posterior interdigitation, and incisor imbrication. The advantages and limitations of this procedure are outlined. The available information strongly suggests that the extraction of second molars relieves crowding in the posterior part of the arch, causes faster eruption of third molars, and diminishes the number of unerupted and/or impacted third molars. Consideration of the decrease in the number of impacted third molars after second molar extraction should be balanced with the fact that the extracted teeth are usually sound and are unimpacted. In addition, the third molars that do erupt frequently are poorly angulated and/or in poor contact with the first molars. This will necessitate an additional "late" period of fixed-appliance therapy to bring these teeth into good occlusion.

Adolescent↗

PubMedDate not supplied

[Orthodontic treatment results with dental arch anomalies in children and adolescents with and without removal of the teeth].

Patients were aged 6 to 15 years. The first group (197 patients) was treated without teeth extraction, 2nd group had teeth extracted. The treatment of dentition anomalies was effective both in decidual and permanent occlusion. The duration of treatment, number of visits per one definitive course were virtually equal in both groups. The authors believe teeth extraction expedient only in grade II constriction of dental arches, grade I to II construction of apical basis and medial teeth shift with space unavailable for restricted teeth at least for 1/2 crown width, and in absolute or relative macrodontia.

Adolescent↗

PubMed2003

Prevalence of third molar impaction in orthodontic patients treated nonextraction and with extraction of 4 premolars.

The purposes of this study were to confirm that premolar extraction treatment is associated with mesial movement of the molars concomitant with an increase in the eruption space for the third molars and to test the hypothesis that such treatment reduces the frequency of third molar impaction. Lateral cephalograms, panoramic or periapical radiographs, and study models made before (T1) and after (T2) treatment and a minimum of 10 years postretention (T3) of 157 patients were selected from the postretention sample at the Department of Orthodontics of the University of Washington, Seattle. Treatment for 105 patients included the extraction of 4 premolars; the other 53 were treated nonextraction. These patients represented all the extraction and nonextraction patients in the sample who had at least 1 third molar at T1 or T2 and who showed evidence of full eruption or closure of the root apex at T2 or T3. Student t tests showed higher scores for third molar impaction (P <.01), less mesial movement of the molars from T1 to T2 (P <.01), and smaller retromolar space at T2 (P <.001) in both arches of the nonex patients than in the ex patients. Similarly, molar movement was more mesial from T1 to T2 in the maxilla (P <.01) and in the mandible (P <.05), and the retromolar space was larger in both arches (P <.001) of the patients with eruption than in those with impaction of the third molars. Our results suggest that premolar extraction therapy reduces the frequency of third molar impaction because of increased eruption space concomitant with mesial movement of the molars during space closure.

Adolescent↗

PubMed1996

Case report SB: long-term follow-up on Class II treatment with first molar extractions.

Widespread acceptance of water fluoridation has greatly reduced the need for molar extractions. When treating Class II malocclusions that require the removal of teeth in the maxillary arch only, consideration should be given to the first molars as well as the more commonly extracted first premolars. This report describes such a case. The patient's active treatment ended in 1979, shortly before he left for college. After one retention visit, he was not seen again until he turned up in the early 1990s' literally on our doorstep, to practice general dentistry across the hall!

Adolescent↗

PubMed2003

Effects of extraction and nonextraction treatment on class I and class II subjects.

This study aims to examine the profile as well as the dentoalveolar and skeletal effects of extraction or nonextraction treatment in a wide range of patients including Class I and Class II, division 1 cases. Results achieved with extraction and nonextraction modalities have also been compared. The study was performed on pretreatment and posttreatment lateral cephalograms of 87 orthodontic patients. There were no significant differences between the pretreatment values of extraction and nonextraction Class I groups, whereas SN-GoGn (degrees), maxillary incisor to A-Po (degrees), mandibular incisor to A-Po (mm), Co-Gn (mm), overjet (mm), and overbite (mm) measurements of extraction Class II group were significantly higher before the treatment. After treatment, these differences were eliminated in the Class II group; however, incisors were significantly protruded in both nonextraction groups. No other differences in profile or lip position were found between the extraction and nonextraction groups. The results of this study indicate that in successfully treated cases, whether by extraction or nonextraction, the same soft and hard tissue profile posttreatment end points were reached except for the incisor positioning, which is rather easier to anticipate than profile and soft tissue changes. The simple statement that extraction means a more retrusive or dished-in profile seems to be unacceptable. It seems that a more thorough assessment and investigation including pretreatment extent of crowding and factors related to anchorage, soft tissue thickness, and strain should be carried out.

Adolescent↗

PubMed1997

Influence of facial growth pattern on outcome of extraction therapy.

The present clinical-radiological study analyzes orthodontic casts and lateral cephalometric X-rays (at start and finish of orthodontic treatment) of 56 extraction cases, most of them adolescent patients who had 4 teeth extracted. The test group was classified into 3 morphological categories according to growth patterns. For comparison purposes, cephalometric findings of morphologically matching non-extraction groups as well as corresponding data from the literature were used. There was no deepening of overbite in any of the extraction cases in the different test groups. However, an average bite opening of 1.2 mm was found in patients with a neutral or horizontal growth pattern. Irrespective of the growth pattern, a significant increase in anterior and posterior facial height as well as a mean reduction of the ANB angle between 0.9 degrees and 1.3 degrees was found in the different extraction groups. These results matched those of the corresponding nonextraction control groups. At the end of treatment, the longitudinal axis of the upper incisors appeared too steep (retruded). Overall, the individual growth pattern was found to be of very little relevance to treatment results, provided a well considered treatment plan had been drawn up.

Adolescent↗

PubMed1992

The influence of extraction and nonextraction orthodontic treatment on brachyfacial and dolichofacial growth patterns.

The effects of extraction and nonextraction orthodontic treatment mechanics on patients with dolichofacial and brachyfacial growth patterns between one and two standard deviations were studied. Groups underwent treatment of either nonextraction or extraction of four premolars with the appropriate mechanics for the facial type. Changes in the facial axis and correlation between maxillary molar movement and facial axis change were measured. A positive correlation was found between the amount of anteroposterior movement of the upper molar and change in the facial axis in brachyfacial and dolichofacial patients undergoing nonextraction treatment. A weak correlation was found in the extraction treatment groups. No statistically significant difference was found in the facial axis change among any of the groups studied, regardless of facial type or plan of treatment. There were indications of a more severe opening of the facial axis (Ba-Na plane to constructed gnathion) with greater degrees of maxillary molar distal movement in both facial patterns studied.

Adolescent↗

PubMed1993

The effect of extraction of four second permanent molars on the incisor overbite.

Changes in incisor overbite were compared in 33 subjects who had four second molars extracted and 33 untreated subjects. There was an average increase in overbite of 0.7 mm in the extraction group, significantly different from an average decrease of -0.8 mm in the control group. The tendency to increase in overbite was greater in subjects whose presenting overbite was already reduced. The mechanism responsible for overbite reduction appeared to be a slight distal movement of the dentition, with retroclination of incisors and increase in inter-incisal angle.

Adolescent↗

PubMed1989

[A comparative study of cephalometric variation of the skeletal and dentoalveolar structures after treatment with the Begg, Ricketts and edgewise technic in cases of Class I and Class II malocclusions treated with and without extractions].

Eliminating, in a first step, the growth effect on the modifications of the skeletal and alveolo-dental structures thanks to the cephalometric analysis of cases not treated, we study the therapeutic control of skeletal Classes I and II (treated with or without extraction) successively in the BEGG, RICKETTS and EDGEWISE technics. For that, we analyse statistically the cephalometrics variations comparing the differents angles and measurements of the RICKETTS, TWEED and STEINER analyses before and after treatment. Thus, we evaluate the bi-dimensionnals, antero-posterior and vertical modifications that an take place during the treatment respectively in the three technics.

Alveolar Process↗

PubMed1984

Clinical application of prostaglandin E1 (PGE1) upon orthodontic tooth movement.

Chemically produced prostaglandin E1 (PGE1) was administered in clinical cases of orthodontic tooth movement. In the first phase, lingual arch springs were applied on both sides of the maxilla to upper first premolars which were scheduled for extraction. One side received submucosal injections of PGE1 and the other received vehicle injections. The rate of tooth movement in the buccal direction approximately doubled on the side of several PGE1 injections as compared to the control side. In the second phase, the PGE1 injections were applied in canine-retraction cases for up to 3 weeks in first-premolar-extraction cases. The rate of distal canine movement was almost double on the side receiving PGE1 injections as compared to the vehicle-injected side. In the third phase, the PGE1 injections were applied on routine canine retraction in first-premolar-extraction cases. The rate of distal canine movement was almost 1.6-fold on the side of PGE1 injections as compared to the vehicle-injected side. Throughout this study, no side effects were observed macroscopically in the gingiva and roentgenographically in the alveolar bone, except for a slight pain reaction consistent with orthodontic tooth movement.

Alprostadil↗

PubMed1991

A longitudinal study of the condition of first permanent molars in a group of adolescents with special reference to elective orthodontic tooth extraction.

The aim of this study was to investigate changes in the condition of first permanent molars over the teenage years, with special reference to adolescents who lost premolar teeth for orthodontic purposes. A total of 453 South Wales schoolchildren (219 males and 234 females) were examined at the ages of 11-12 and 19-20 years. At 11-12 years, 89.6 per cent of the cohort had all four first permanent molars, while 3.3 per cent had already lost these teeth. Of those first permanent molars present, 61.7 per cent had some caries experience. At age 19-20, 80.6 per cent of subjects retained four first permanent molars while 4.4 per cent had none. Of the first permanent molars present, 80.6 per cent had been affected by caries. In 60 per cent of the 186 subjects (75 males and 111 females) who had lost premolar teeth in the course of orthodontic treatment, a sound premolar was extracted in preference to a first permanent molar which already had evidence of dental disease. At age 19-20 years, the majority of the first permanent molars were restored and otherwise sound, though a small number which had been restored at age 11-12 years had been lost due to caries.

Adolescent↗

PubMed1989

[Impact of early extraction of the 1st molars on vertical dimension].

Early extractions of first permanent molars, done on twenty cases without any orthodontic treatment, have not shown, following the Student's analysis, any statistical difference relative to a pilot group as far as the angles. SN- ANS- PNS, SN-OP, SN-GoGn, FMA, Y-axis are concerned. On the other hand, it has been revealed a closure of the angle ANS- Xi- MP associated with an opening of the mandibular arch.

Cephalometry↗

PubMed2003

Orthodontic preparation for orthognathic surgery: how long does it take and why? A retrospective study.

We investigated the duration of pre-operative orthodontic treatment of patients who had combined orthodontic and orthognathic treatment and examined the variables that influenced this. Records of patients who had undergone such treatment in the past 5 years were collected (n=65) from three consultant orthodontists and one Senior Specialist Registrar/Fixed Term Training Appointment (FTTA). The number of days from placement of the first active orthodontic component to the day that final planning impressions were taken was used to calculate the duration of treatment before the patient was ready for operation. The variables investigated were: sex, age, malocclusion, extractions (excluding third molars), and the clinician. The median duration of pre-operative treatment was 17 months (range 7-47). Only the orthodontist appeared to affect this duration, but this requires further investigation as it may merely reflect variation in other factors such as compliance. We conclude that patients should be informed that the pre-operative phase may last 12-24 months.

Adolescent↗

PubMed1989

The closure of residual extraction spaces by means of traction screws: a report of two cases.

In those cases judged to be suitable for treatment by extractions in both arches and the use of upper removable appliances alone, the closure of excess residual space relies on mesial drift of the buccal segments. If opposing residual spaces are unequal in extent, there is a risk that space closure will be incomplete. Two cases are presented where a removable appliance was used to move a buccal segment mesially using a traction screw, and thereby close the excess residual space.

Adolescent↗

PubMed1987

Lower premolar extraction/removable plastic Herbst treatment for mandibular retrognathia.

The patient was a 12-year-old girl with a Class I malocclusion characterized by maxillary arch width constriction, dental crowding, and mandibular retrognathia. Treatment goals related to the chief compliant were anterior mandibular repositioning, maxillary arch expansion, and dental alignment. Because the preexisting overjet was minimal and prevented adequate anterior repositioning of the mandible, lower first premolar extraction was recommended to increase the overjet and allow greater anterior repositioning. Treatment was divided into four stages: (1) extraction of mandibular first premolar teeth, alignment, space closure, and an increase in the overjet, (2) anterior mandibular repositioning with a removable plastic Herbst appliance, (3) arch alignment and detailing of the occlusion with full fixed appliances and a tooth positioner, and (4) retainers. At the end of treatment, the patient had an acceptable dental alignment with a Class III molar relationship and an improvement in facial appearance.

Activator Appliances↗

PubMed1992

The duration of orthodontic treatment.

Characteristics of the patient, the treatment plan, and the practitioner's office were examined to evaluate causes for variation in the duration of orthodontic treatment. From six offices 118 patients were evaluated. All patients were treated in a single phase with fixed appliances. Appliances were worn for an average of 23.1 months. The mean duration for offices ranged from 19.4 to 27.9 months. Thirty-eight percent of the patients had extractions, and 32% wore headgear. Fifty percent of the variation in treatment duration among patients was explained by a five-step multiple regression equation. The variables entering this equation were (1) number of extracted premolars, (2) number of broken appointments, (3) pretreatment mandibular plane angle, (4) pretreatment ANB angle, and (5) pretreatment Salzmann Index. Observations within each office suggested that the time spent by individual clinicians in detailed finishing, which would not be detected by measures such as the Salzmann Index, was an important source of unexplained variation in treatment duration.

Adolescent↗