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Clinical Oral Investigations
Published in: Clinical Oral Investigations 4/2016

01-05-2016 | Original Article

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

Authors: Christian Kirschneck, Peter Proff, Claudia Reicheneder, Carsten Lippold

Published in: Clinical Oral Investigations | Issue 4/2016

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Abstract

Objectives

The belief of many orthodontists that premolar extraction therapy leads to a loss of vertical dimension and an aggravated facial profile often predetermines a non-extraction approach. We investigated the short-term effects of systematic premolar extraction in borderline cases for extraction therapy on dentofacial parameters, especially vertical dimension and facial profile.

Materials and methods

Of 50 juvenile borderline cases for extraction treatment with a distinct sagittal overjet of 6–9 mm and dental crowding of >6 mm, 25 had all first premolars extracted, whereas the 25 control patients received non-extraction orthodontic treatment with corresponding fixed and removable appliances. Patient selection by multivariate cluster analysis ensured homogeneity at baseline regarding dentoskeletal parameters. Parameter changes were determined with radiographic cephalograms and compared between the extraction and non-extraction group.

Results

The systematic extraction of premolars in borderline patients with a distinct sagittal overjet and crowding did not significantly influence sagittal or vertical skeletal dimension, while leading to a slightly more concave lip profile due to incisor retraction compared to the non-extraction control group.

Conclusions

The influence of premolar extractions on facial profile is often overestimated, since only slight changes in lip profile are to be expected. In integrated treatment planning, the extraction decision should not be primarily based on concerns about the aggravation of facial profile and loss of vertical dimension.

Clinicial relevance

The decision, whether to extract healthy premolars in borderline patients for extraction therapy, is difficult to make. Our study clarifies the repercussions on cephalometric dentofacial parameters, facilitating future orthodontic extraction decisions.
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Metadata
Title
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
Authors
Christian Kirschneck
Peter Proff
Claudia Reicheneder
Carsten Lippold
Publication date
01-05-2016
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 4/2016
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-015-1574-5

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