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Skeletal and dental effects of serial extractions performed with or without maxillary expansion-A retrospective
Vincenzo Quinzi1, Simone Ettore Salvati1, Fabrizio Lerda2
1Department of Life, Health & Environmental Sciences, Postgraduate School of Orthodontics, University of L'Aquila, L'Aquila, Italy.
Objectives:
The study aimed to compare severe crowding treatment's skeletal and dental effects by serial extractions or maxillary expansion and serial extractions in the mixed dentition phase.
Setting And Sample Population:
The retrospective controlled study included lateral cephalograms of 78 subjects aged 8.5 ± 1.4 years, 52 consecutively treated because of severe crowding, and 26 untreated controls matched for baseline age and observational period.
Methods:
Subjects were clustered according to the treatment modality, either serial extraction (EX) or expansion and extraction (EXP-EX) group. Sagittal and vertical skeletal as well as dental cephalometric parameters were assessed at baseline and after the eruption of all permanent posterior teeth, and group comparisons were performed.
Results:
Both treatment modalities significantly affected the vertical skeletal parameters in terms of decreasing the mandibular and occlusal plane inclination and increasing the facial height index. A distinct treatment effect on the gonial angle was observed, with a significant decrease in its superior part observed in both extraction groups. The annualized changes in the superior part of the gonial angle significantly differ (P = .036) between the Control (-0.04 ± 0.6), EX (-0.44 ± 0.6) and EXP-EX (-0.34 ± 0.5) groups. Upper and lower incisor inclination did not change significantly in any of the groups; however, the interincisal angle at follow-up was significantly smaller in the Control compared with both treated groups.
Conclusions:
Serial extractions and a combination of maxillary expansion and serial extractions have similar significant skeletal effects, mainly affecting vertical cephalometric parameters if performed during the pre-pubertal growth phase.
