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Mandibular changes secondary to serial extractions compared with late premolar extractions and controls
Esther Feldman1, David B Kennedy2, Jolanta Aleksejuniene3
1Formerly, graduate student, Department of Orthodontics, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada; private practice, Los Angeles, Calif.
Summary
Serial extractions lead to steeper occlusal curves and tooth tipping. Orthodontic treatment in serial extraction patients uprights teeth and flattens curves, differing from late premolar extraction outcomes.
Area of Science:
- Orthodontics
- Dental Arch Analysis
- Craniofacial Development
Background:
- Treatment duration in serial extraction and late premolar extraction cases may correlate with occlusal curve flattening.
- Understanding these differences is crucial for optimizing orthodontic treatment planning.
Purpose of the Study:
- To compare tooth tipping and occlusal curve changes between serial extraction, late premolar extraction, and untreated control groups.
- To analyze the effects of different extraction protocols on dental arch morphology.
Main Methods:
- Collected serial records (dental casts, cephalometric radiographs) from 90 subjects (30 controls, 30 serial extraction, 30 late premolar extraction).
- Measured tooth angulation (incisor, canine, molar) and analyzed mandibular occlusal curves (Curve of Spee, incisor intrusion, canine intrusion) at three time points (T0, T1, T2).
Main Results:
- Serial extraction patients exhibited distal tipping of incisors and canines, and increased mesial molar tipping after initial drift (T1).
- Post-orthodontic treatment (T2), serial extraction patients showed steeper occlusal curves compared to controls and late premolar extraction patients, except for the Curve of Spee.
- Orthodontic intervention in serial extraction cases resulted in incisor/canine proclination and molar uprighting.
Conclusions:
- Serial extractions result in distinct occlusal curve characteristics and tooth positioning compared to late premolar extractions.
- Orthodontic management following serial extractions effectively addresses tooth tipping and aims to flatten occlusal curves.
- Findings provide insights into managing occlusal development and treatment timing in extraction cases.
