A comparison of results of second molar and first premolar extraction treatment

The purpose of this study was to examine treatment results of maxillary and mandibular second molar extraction cases and compare them with treatment results of maxillary and mandibular first-premolar extraction cases. Records of 22 maxillary and mandibular second-molar extraction cases and 22 maxillary and mandibular first-premolar extraction cases were evaluated. For each case, pretreatment and posttreatment lateral cephalograms were traced and several cephalometric parameters were compared. From the pretreatment and posttreatment panoramic radiographs, angulations of the maxillary and mandibular third molars were evaluated. Average treatment time, in months, was recorded for both groups. The data obtained from each group were analyzed for statistical difference. The results showed that the two groups had fewer differences than indicated by advocates of second-molar extractions. Analysis of the cephalometric data demonstrated only a few statistical differences between the groups. The maxillary and mandibular incisors in the premolar group were retracted a significantly greater amount than in the second-molar group. The maxillary and mandibular first molars were protracted a greater amount in the premolar group than in the second-molar group. The lower lips in the premolar group were retracted a greater amount than in the second-molar group. The resulting facial profile after extraction of second-molars appears to be no different from that obtained after extraction of first premolars. The pantographic evaluation of the changes in third-molar angulation were not statistically different. In both groups, the maxillary third molars showed an improvement in third-molar angulation, while the mandibular third-molars showed an undesirable increase in angulation. The average treatment time for both groups was not statistically different.