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Facial changes in extraction and nonextraction patients

J C Boley, J P Pontier, S Smith

    The Angle Orthodontist
    |December 16, 1998
    PubMed
    Summary
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    Orthodontic premolar extraction does not significantly impact post-treatment facial aesthetics. Experienced dentists and orthodontists could not distinguish between extraction and non-extraction cases based on facial appearance alone.

    Area of Science:

    • Orthodontics
    • Dentofacial Aesthetics

    Background:

    • Premolar extraction is a common orthodontic treatment modality.
    • Concerns exist regarding potential negative impacts on facial aesthetics following premolar extraction.

    Purpose of the Study:

    • To investigate differences in post-treatment facial profiles between non-extraction and four-premolar extraction orthodontic patients.
    • To assess the ability of dental professionals to differentiate between these treatment types based on facial appearance.

    Main Methods:

    • Part 1: 192 dentists and orthodontists evaluated facial photographs of 25 non-extraction and 25 four-premolar extraction patients.
    • Part 2: Cephalometric analysis of pretreatment and posttreatment profiles was performed.
    • H-line values were used to assess facial profile aesthetics.

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    Main Results:

    • Dentists and orthodontists could not reliably distinguish between extraction and non-extraction cases (mean accuracy 54%).
    • No significant differences were found in post-treatment facial profiles between the two groups.
    • Mean H-line values for both groups fell within acceptable aesthetic ranges.

    Conclusions:

    • Facial appearance alone is insufficient to determine if orthodontic treatment involved premolar extraction.
    • Properly diagnosed and treated orthodontic cases, whether extraction or non-extraction, yield comparable facial aesthetic outcomes.
    • Avoiding premolar extraction due to unfounded fears of detrimental facial effects is not justified.