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Reinventing serial extraction with a fresh perspective: does it inspire a change in current practice?
Soumya Narayani Thirumoorthy1, Saumiya Gopal2
1Associate Orthodontist, Smilelife Orthodontics, Corpus Christi, TX, USA. snt270@nyu.edu.
Evidence-Based Dentistry
|August 31, 2023
Summary
Serial extraction, with or without expansion, significantly impacts vertical skeletal dimensions in children with severe crowding. Both methods yield comparable cephalometric results when performed before puberty.
Area of Science:
- Orthodontics
- Craniofacial development
- Dental arch analysis
Background:
- Severe dental crowding is a common orthodontic concern.
- Serial extraction is a treatment modality to manage severe crowding.
- The role of expansion in conjunction with serial extraction requires further analysis.
Purpose of the Study:
- To compare the skeletal and dental effects of serial extraction with and without palatal expansion.
- To analyze cephalometric changes in severe crowding cases treated with serial extraction.
- To evaluate the impact of treatment timing (pre-pubertal) on outcomes.
Main Methods:
- Retrospective controlled study utilizing lateral cephalograms.
- Sample of 78 children (8.5 ± 1.4 years): 52 treated for severe crowding, 26 controls.
- Treated cases divided into serial extraction (EX) and serial extraction with expansion (EX-EXP) groups.
Main Results:
- Significant vertical skeletal changes observed, including decreased mandibular and occlusal plane angles.
- Increased facial height index and decreased upper gonial angle in extraction groups.
- No significant inter-incisal angle change, but controls had smaller angles at follow-up.
Conclusions:
- Serial extraction alone or with expansion shows comparable skeletal cephalometric findings.
- Treatment primarily affects the vertical dimension.
- Effective outcomes are achieved when performed before the pubertal growth spurt.
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