Posttreatment stability following therapy using passive self-ligating brackets: extraction vs. nonextraction

This study aimed to evaluate the effects of lower premolar extraction on posttreatment stability one year following fixed orthodontic treatment with passive self-ligating brackets (Damon system, Ormco, Orange, CA, USA).

All patients were treated with fixed orthodontic appliances using passive self-ligating brackets (Damon). For retention, removable Hawley retainers were used. Two groups of patients were included in the study. Each group consisted of 23 patients: group Ex consisted of 10 male and 13 female patients (13.4 ± 1.6 years old) with extraction of lower first premolars and group NonEx consisted of 11 male and 12 female patients (13.4 ± 3.9 years old) without dental extractions. The patients’ dental models and photographs were assessed at T0 (pretreatment), T1 (the end of active orthodontic treatment: 3.3 ± 1.0 years in the Ex and 2.3 ± 0.8 years in the NonEx group) and at T2 (1 year posttreatment). All lower casts were scanned and the following dental parameters were recorded and compared between the two groups: intercanine width (ICW), anterior arch width (AAW), intermolar width (IMW), Little’s irregularity index (LII) and gingival recessions.

An increase in ICW (group Ex: 1.20 ± 2.51 mm and group NonEx: 0.84 ± 1.48 mm) by the end of active treatment (T1; P < 0.05), as well as a relapse regarding the ICW (group Ex: −0.1 ± 0.47 mm and group NonEx: −67% ± 0.38 mm) one year post-treatment (T2) were recorded in the samples. Relapse in the non-extraction group was statistically and clinically significant, whereas ICW values remained relatively stable in the extraction group during the posttreatment period (T1–T2). The irregularity index decreased during treatment (group Ex: −8.79 ± 6.36 mm and group NonEx: −5.24 ± 2.99 mm) and relapsed in both groups (group Ex: 0.57 ± 90 mm and group NonEx: 0.27 ± 0.53). The rate of relapse in LII was correlated to the relapse rate of ICW. A reduction of IMW was recorded in the Ex group (−1.89 ± 1.82 mm) during active treatment (P < 0.05), which remained stable 1 year posttreatment. AAW increased in both groups (group Ex: 2.77 ± 1.77 mm and group NonEx: 1.77 ± 2.04 mm) throughout active treatment and remained stable at T2.

Intergroup comparison revealed that ICW remained stable 1 year posttreatment in the Ex group, whereas high relapse of ICW was recorded in the NonEx group. Furthermore, risk of a relapse of LII appears to be higher in cases with a relapse of the ICW.