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Phan AH, Lam PH, Le LD, Le SH. Improvement of the Impacted Level of Lower Third Molars After Orthodontic Treatment. Int Dent J 2023; 73:692-700. [PMID: 36868979 PMCID: PMC10509441 DOI: 10.1016/j.identj.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/29/2022] [Accepted: 01/18/2023] [Indexed: 03/05/2023] Open
Abstract
OBJECTIVES The early or delayed surgical removal of an asymptomatic lower third molar (M3) in orthodontic patients remains controversial. This study aimed to determine the changes in the impacted level of M3 such as angulation, vertical position, and eruption space, after orthodontic treatment in 3 groups, namely non-extraction (NE), first premolar (P1) extraction, and second premolar (P2) extraction. METHODS Relevant angles and distances related to 334 M3s from 180 orthodontic patients were assessed pre- and posttreatment. Angle between lower second molar (M2) and M3 (M3-M2) was used for evaluating M3 angulation. For M3 vertical position, distances from occlusal plane to the highest cuspid (Cus-OP) and fissure (Fis-OP) of M3 were used. Distances from the distal surface of M2 to anterior border (J-DM2) and centre (Xi-DM2) of the ramus were used for assessing M3 eruption space. Pre- and posttreatment values of the angle and distance in each group were compared using a paired-sample t test. Measurements of the 3 groups were compared using analysis of variance. Hence, multiple linear regression (MLR) analysis was used to determine significant factors that impacted changes in M3s' related measurements. Independent factors used for MLR analysis included sex, treatment starting age, pretreatment respective angle/distance, and premolar extraction (NE/P1/P2). RESULTS M3 angulation, vertical position, and eruption space at posttreatment were significantly different from those at pretreatment in all 3 groups. MLR analysis showed that P2 extraction significantly improved M3 vertical position (P < .05) and eruption space (P < .001). P1 extraction significantly decreased Cus-OP (P = .014) and eruption space (P < .001). Treatment starting age was significant factor that affected Cus-OP (P = .001) and M3 eruption space (P < .001). CONCLUSIONS After orthodontic treatment, M3 angulation, vertical position, and eruption space changed in favour of the impacted level. These changes in the 3 groups were clearer in order: NE, P1, and P2, respectively.
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Affiliation(s)
- An Huynh Phan
- Department of Maxillofacial Surgery, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Phuong Hoai Lam
- Department of Maxillofacial Surgery, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Lanh Duc Le
- Department of Oral Implantology, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Son Hoang Le
- Department of Oral Surgery, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
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Benson PE, Alshawy E, Fenton GD, Frawley T, Misra S, Ng T, O'Malley P, Smith G. Extraction vs nonextraction of premolars for orthodontic treatment: A scoping review examining the extent, range, and characteristics of the literature. Am J Orthod Dentofacial Orthop 2023; 164:368-376. [PMID: 36967315 DOI: 10.1016/j.ajodo.2023.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION The debate about whether malocclusion can or should be treated with or without extraction of premolars continues. This scoping review quantifies the literature, summarizes the outcomes researched and methods, and proposes a way to reduce uncertainty in this area. METHODS Electronic and gray literature searches were undertaken without language restriction, but non-English language titles and abstracts were not translated. A minimum of 2 people independently screened the titles and abstracts. RESULTS Searches identified 9010 articles, of which 3851 were duplicates; 5159 were screened, and 4617 were excluded (1092 laboratory or animal studies, 1219 case reports or series, 2306 with no information). By consensus, 399 articles contained information concerning differences between orthodontic patients treated with or without premolar extractions (143 were unclear). The majority (n = 372) reported outcomes in 8 areas. Fifty-seven were review articles (32 systematic reviews and 25 nonsystematic reviews or opinions). The most common research design in the remainder was a cohort (n = 280, 82% of 342 articles reporting primary data), of which a very large majority were considered retrospective (n = 249, 89% of articles reported for subjects over ≥2 time points). Only 28 (8% of articles reporting primary data) were judged to involve prospective data collection (4 randomized controlled trials [RCTs], 23 cohorts, 1 unclear design). Excluding reviews and unclear articles, 99% (332 out of 336) were considered observational research and only 1% were interventional. CONCLUSIONS There was limited low-quality evidence that extracting premolars in orthodontic patients have a possible negative effect in 2 outcome areas and a positive effect in 1 outcome area. Most study reports were of low methodological quality, and further reviews are unlikely to provide new information. Investigators should concentrate on collecting primary data of outcomes important to patients. A protocol has been made available to help reduce methodological differences, assist future meta-analyses and increase the generalizability of findings: https://doi.org/10.17605/OSF.IO/CQ49Y.
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Affiliation(s)
- Philip E Benson
- Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom.
| | - Ebrahim Alshawy
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Gavin D Fenton
- Orthodontic Departments, Cumberland Infirmary, North Cumbria Acute Hospitals NHS Trust and Newcastle Dental Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Tom Frawley
- Orthodontic Department, Charles Clifford Dental Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Sangeeta Misra
- Orthodontic Department, Charles Clifford Dental Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Teresa Ng
- Shropshire Community Dental Service NHS Trust, Shrewsbury, United Kingdom
| | - Paul O'Malley
- Orthodontic Department, Charles Clifford Dental Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Gillian Smith
- Orthodontic Department, James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesborough, United Kingdom
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Nguyen A, Caplin J, Avenetti D, Durfee S, Kusnoto B, Sciote JJ, Nicholas CL. A longitudinal assessment of sex differences in the growth of the mandibular retromolar space. Arch Oral Biol 2022; 143:105547. [PMID: 36162340 DOI: 10.1016/j.archoralbio.2022.105547] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/25/2022] [Accepted: 09/17/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess longitudinal variation in patterns of retromolar space growth, with regard to sex and cervical vertebrae maturation. DESIGN We utilized serial lateral cephalograms from three craniofacial growth studies (Denver, Iowa, Oregon), measuring retromolar space and cervical vertebrae maturation in 99 subjects (56% male) from 8 to 18 years of age for each subject. Repeated measures ANOVA and a linear mixed effects model were used to assess retromolar space growth through time. RESULTS Our analyses revealed an average increase in retromolar space of 8.73 mm from 8 to 18 years. While t-tests failed to find differences in retromolar space growth between males and females at the measured age points, repeated measures ANOVA and linear mixed effects models revealed modest differences in growth trends between sexes, with females having more growth earlier but a younger age of deceleration of growth (between 12 and 14 years of age). CONCLUSIONS Our results confirm large increases in retromolar space through growth, reaching an average of 1.38 mm/year around puberty. Importantly, we add to the conversation regarding sex differences, showing differences in timing of growth. This highlights the importance of using longitudinal data and analytical approaches to address questions of this nature.
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Affiliation(s)
- Annie Nguyen
- Craniofacial Orthodontics, Seattle Children's Hospital, Seattle, WA 98105, USA.
| | - Jennifer Caplin
- Department of Preventive, Pediatric, and Community Dentistry, University of New England, Portland, ME, USA.
| | - David Avenetti
- Department of Pediatric Dentistry, University of Illinois Chicago, Chicago, IL 60612, USA.
| | - Sharon Durfee
- Department of Orthodontics, University of Illinois Chicago, Chicago, IL 60612, USA.
| | - Budi Kusnoto
- Department of Orthodontics, University of Illinois Chicago, Chicago, IL 60612, USA.
| | - James J Sciote
- Department of Orthodontics, Temple University, Philadelphia, PA 19122, USA.
| | - Christina L Nicholas
- Department of Orthodontics, University of Illinois Chicago, Chicago, IL 60612, USA; Department of Anthropology, University of Illinois Chicago, Chicago, IL 60612, USA.
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Aslan BI, Akarslan ZZ, Karadağ Ö. Effects of Angle class II correction with the Forsus fatigue resistant device on mandibular third molars : A retrospective study. J Orofac Orthop 2021; 82:403-412. [PMID: 33666713 DOI: 10.1007/s00056-021-00281-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 02/02/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE The goal was to evaluate the effects of Angle class II malocclusion treatment using the Forsus fatigue resistant device (FRD, 3M, St. Paul, MN, USA) on the position and angulation of mandibular third molars and retromolar space. PATIENTS AND METHODS In all, 58 class II patients (mean age 13.6 ± 1.8 years) treated with the FRD (FRD group) were compared with 51 class I patients (mean age 13.5 ± 1.6 years) who underwent orthodontic treatment (control group). A total of 109 mandibular third molars in the FRD group and 91 in the control group were evaluated. Changes in the retromolar space, angulation of the second (ɣ) and third molars (β), and the angle between these teeth (α) were assessed with panoramic radiographs taken at the beginning and the end of the treatment. Data were statistically analyzed. RESULTS At the end of the treatment, there were significant increases in ɣ and β in the FRD group and ɣ in the control group (p < 0.05). The decrease in α in the FRD group and increase in the control group were not significant (p > 0.05); however, this change led to a small significant change between the groups (p < 0.05). The retromolar space significantly increased in the FRD group compared to the control group (p < 0.05). No significant correlation was found between retromolar space and third molar uprighting in any of the groups (p > 0.05). CONCLUSION Class II correction with FRD led to mesialization of the lower arch which provided an increase in the retromolar space. Little improvement in the uprighting of the third molars occurred.
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Affiliation(s)
- Belma I Aslan
- Department of Orthodontics, Gazi University Dentistry Faculty, Ankara, Turkey.
| | - Zühre Z Akarslan
- Department of Dentomaxillofacial Radiology, Gazi University Dentistry Faculty, Ankara, Turkey
| | - Özge Karadağ
- Faculty of Science, Department of Statistics, Hacettepe University, Ankara, Turkey
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Pan F, Yang Z, Wang J, Cai R, Liu J, Zhang C, Liao W. Influence of orthodontic treatment with premolar extraction on the spatial position of maxillary third molars in adult patients: a retrospective cohort cone-bean computed tomography study. BMC Oral Health 2020; 20:321. [PMID: 33176777 PMCID: PMC7661228 DOI: 10.1186/s12903-020-01314-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/04/2020] [Indexed: 02/05/2023] Open
Abstract
Background Based on low-dose radiation Cone-bean computed tomography (CBCT) images, This study aims to establish a space coordinate system, which offers more precise and comparable evaluation on changes of maxillary third molars influenced by orthodontic treatment with premolar extraction in adults. The system suggests promising application prospect in future studies related to CBCT superimposition and evaluation for its feasibility and efficiency. Methods Forty-nine maxillary third molars from 27 patients (mean age, 20.78 years) were included. CBCT images were obtained before and after orthodontic treatment with premolars extracted (mean treatment duration, 31.47 months). The changes in the position, angulation, and rotation of the third molars were evaluated with a space coordinate system using four landmarks: anterior nasal spine (ANS), posterior nasal spine (PNS), left and right orbitales. Results After orthodontic treatment, the third molars moved forward (adjusted mean, 1.44 mm) (p < 0.001) and downward (adjusted mean, 2.87 mm) (p < 0.001) accompanied by outward rotation of the crowns (adjusted mean, 5.38°) (p = 0.001), while changes in angulation were insignificant. Conclusions This was the first study to systematically investigate the spatial position change of maxillary third molars in adult patients who received orthodontic treatment with premolar extraction. During the process, maxillary third molars moved downward and forward accompanied by outward rotation of the crowns. Orthodontists should take tooth movement potential into consideration when making extraction plans.
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Affiliation(s)
- Fangwei Pan
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Zhentao Yang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jian Wang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ruilie Cai
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jialing Liu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Chenghao Zhang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Wen Liao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Abbassy MA, Mitwally RA. Atypical extraction in Class I malocclusion: A case report. J Orthod Sci 2020; 9:9. [PMID: 33110768 PMCID: PMC7585465 DOI: 10.4103/jos.jos_1_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 05/12/2020] [Accepted: 05/16/2020] [Indexed: 11/30/2022] Open
Abstract
The treatment of Angle Class I malocclusion by atypical extraction is rather challenging. The extraction of four first premolars often manages it. However, in cases of compromised and non-restorable teeth, the extraction decision may be altered, making the anchorage and the treatment mechanics more challenging. This article reports the clinical case of a 16-year-old patient from Sudan who presented with a chief complaint “My teeth are crooked and sticking out.” He had Angle Class I malocclusion with a bimaxillary dentoalveolar protrusion. He had severe crowding in both arches and localized marginal gingivitis related to an ectopically erupted upper right canine (UR3) and lower right first premolar (LR4). The patient had a provisional restoration in the lower right first molar (LR6). Extraction of three first premolars and one first molar was the alternative of choice for this treatment, which restored function, providing improved periodontal health, achieved the desired facial esthetics, and allowed finishing with a stable and balanced occlusion. Management of angle class I malocclusion with atypical extraction patterns should be performed with careful mechanics and anchorage planning to obtain good results.
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Affiliation(s)
- Mona A Abbassy
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Alexandria University, Alexandria, Egypt
| | - Rania A Mitwally
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Orthodontic, North Dental Specialty Center, Ministry of Health, Jeddah, Saudi Arabia
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Shashidhar K, Castelino CK, Kuttappa MN, Nair RA, Soans CR, Nair HS. Third Molar Angulation Changes in Class II Div I Malocclusion Subjects Treated with Extraction of Four Premolars: A Retrospective Study. J Int Soc Prev Community Dent 2020; 10:591-596. [PMID: 33282768 PMCID: PMC7685268 DOI: 10.4103/jispcd.jispcd_342_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 05/13/2020] [Accepted: 03/20/2020] [Indexed: 11/11/2022] Open
Abstract
Aim: The aim of this study was to assess the changes in maxillary and mandibular third molar inclinations in individuals with class II div 1 malocclusion, before and after orthodontic treatment with extraction of all four first premolars. Materials and Methods: This retrospective study consisted of the pretreatment and posttreatment records of 30 patients that were obtained from the archives of the department of orthodontics and dentofacial orthopedics in A B Shetty Memorial Institute of Dental Sciences. The maxillary third molar’s relation to the palatal plane and the mandibular third molar’s relation to the mandibular plane were measured. The paired t test was used to calculate pre- and posttreatment changes. A value of P < 0.05 was considered to be statistically significant. Results: The maxillary third molars showed a mean correction of 6.15° (P < 0.001) and the mandibular third molars showed a mean correction of 5.10° (P < 0.001). Conclusion: Maxillary third molars showed more uprighting when compared to the mandibular third molars and that both maxillary and mandibular third molars showed an improvement in their angulations to their respective planes after extraction of the first premolars. However, the results of the study cannot be analyzed to state if the third molars do become fully functional.
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Affiliation(s)
- Keerthan Shashidhar
- Department of Orthodontics and Dentofacial Orthopaedics, A B Shetty Memorial Institute of Dental Sciences, Nitte (Deemed to be University), Mangalore, Karnataka, India
| | - Chrysl Karishma Castelino
- Department of Oral and Maxillofacial Surgery, Father Muller Medical College and Hospital, Mangalore, Karnataka, India
| | - M N Kuttappa
- Department of Orthodontics and Dentofacial Orthopaedics, A B Shetty Memorial Institute of Dental Sciences, Nitte (Deemed to be University), Mangalore, Karnataka, India
| | - Rohit A Nair
- Department of Endodontics and Conservative Dentistry, A B Shetty Memorial Institute of Dental Sciences, Nitte (Deemed to be University), Mangalore, Karnataka, India
| | - Crystal Runa Soans
- Department of Orthodontics and Dentofacial Orthopaedics, A B Shetty Memorial Institute of Dental Sciences, Nitte (Deemed to be University), Mangalore, Karnataka, India
| | - Harikrishnan S Nair
- Department of Pedodontics, Srinivas Institute of Dental Sciences, Mangalore, Karnataka, India
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Abstract
Objective: This analysis discusses common problems with systematic reviews (SRs) and presents a novel solution, the structured critical analysis (SCA) that can be incorporated into a SR or used as an alternative literature review design.Methods: A cross-sectional survey of current SRs related to interdisciplinary restorative dentistry was obtained by evaluating 100 current SRs for their self-reported methodological quality and its effect on scientific validity.Results: The preferred reporting items for systematic reviews and meta-analyses protocol (PRISMA) was used in 99/100 SRs, but only 8/100 reported a low risk of bias. High statistical heterogeneity precluding meta-analysis was found in 44/100 SRs. Only 94 paragraphs/100 SRs provided critical analysis.Discussion: Significant problems were found with current SRs that can compromise their reliability as the premier level of evidence for clinical science research. The reader must be aware of these deficiencies to correctly interpret the SR and cannot rely on the format alone.
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Vranckx M, Ockerman A, Coucke W, Claerhout E, Grommen B, Miclotte A, Van Vlierberghe M, Politis C, Jacobs R. Radiographic prediction of mandibular third molar eruption and mandibular canal involvement based on angulation. Orthod Craniofac Res 2019; 22:118-123. [DOI: 10.1111/ocr.12297] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/17/2018] [Accepted: 01/01/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Myrthel Vranckx
- OMFS‐IMPATH Research GroupDepartment of Imaging and PathologyFaculty of MedicineUniversity of Leuven Leuven Belgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals Leuven Leuven Belgium
| | - Anna Ockerman
- OMFS‐IMPATH Research GroupDepartment of Imaging and PathologyFaculty of MedicineUniversity of Leuven Leuven Belgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals Leuven Leuven Belgium
| | | | - Elke Claerhout
- OMFS‐IMPATH Research GroupDepartment of Imaging and PathologyFaculty of MedicineUniversity of Leuven Leuven Belgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals Leuven Leuven Belgium
| | - Bieke Grommen
- OMFS‐IMPATH Research GroupDepartment of Imaging and PathologyFaculty of MedicineUniversity of Leuven Leuven Belgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals Leuven Leuven Belgium
| | - Annelie Miclotte
- Department of Oral Health Sciences‐OrthodonticsKU Leuven and DentistryUniversity Hospitals Leuven Leuven Belgium
| | - Martine Van Vlierberghe
- OMFS‐IMPATH Research GroupDepartment of Imaging and PathologyFaculty of MedicineUniversity of Leuven Leuven Belgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals Leuven Leuven Belgium
| | - Constantinus Politis
- OMFS‐IMPATH Research GroupDepartment of Imaging and PathologyFaculty of MedicineUniversity of Leuven Leuven Belgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals Leuven Leuven Belgium
| | - Reinhilde Jacobs
- OMFS‐IMPATH Research GroupDepartment of Imaging and PathologyFaculty of MedicineUniversity of Leuven Leuven Belgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals Leuven Leuven Belgium
- Department of Dental MedicineKarolinska Institutet Stockholm Sweden
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Fleming PS, Cunningham SJ, Benson PE, Jauhar P, Millett D. Extraction of premolars for orthodontic reasons on the decline? A cross-sectional survey of BOS members. J Orthod 2018; 45:1-6. [PMID: 30192715 DOI: 10.1080/14653125.2018.1517470] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 08/24/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To obtain the opinion of British Orthodontic Society (BOS) members in relation to possible patterns of prescription of orthodontic extractions over the past 5-10 years and to relate any changes identified to treatment objectives, facial and smile aesthetics, and treatment strategies and adjuncts. DESIGN Cross-sectional questionnaire. SETTING On-line survey of BOS members. METHODS A 14-item on-line questionnaire was sent to orthodontic practitioners for completion. The questionnaire covered demographics, possible changes in frequency of prescribed extractions with specific information concerning the effect of patient age, and the influence of other factors including alternative approaches to space creation, evolving treatment mechanics, smile and facial aesthetics, and retention protocols. RESULTS Two hundred and eight responses were obtained with 95.6% (n = 199) reporting reduced extraction prescription over the last 5-10 years. Overall, 29.9% and 35.5% felt that their threshold for extractions had increased by more than 2 mm in adolescents and adults, respectively. Facial (n = 145; 69.7%) and smile (n = 127; 61.1%) aesthetics, and increased use of inter-proximal reduction (n = 102; 49%) were the factors most frequently reported as having either a moderate or major influence on this trend. Based on ordinal logistical regression analyses, no significant relationship was found between threshold for extractions and work setting (P = 0.675; O.R. 0.51; 95% CI: 0.39, 1.85) or level of orthodontic experience (P = 0.15; O.R. 1.02; 95% CI: 0.15, 1.05), although a higher threshold for extractions was more likely among users of conventional than self-ligating brackets (P = 0.001; O.R. 4.74; 95% CI: 1.95, 11.5). CONCLUSIONS A reduced tendency to prescribe orthodontic extractions over the past 5-10 years among British Orthodontic Society members was identified. Comparative clinical research exploring the relative merits of extraction and non-extraction approaches could be timely.
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Affiliation(s)
- Padhraig S Fleming
- a Barts and The London School of Medicine and Dentistry, Queen Mary University of London , London , UK
| | | | | | - Preeti Jauhar
- a Barts and The London School of Medicine and Dentistry, Queen Mary University of London , London , UK
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Zor ZF, Kaygisiz E, Ates C, Tortop T, Yuksel S. Effects of facemask therapy on the mandibular retromolar space. A follow-up study. Saudi Med J 2018; 39:815-821. [PMID: 30106420 PMCID: PMC6194994 DOI: 10.15537/smj.2018.8.22292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: To evaluate the mandibular retromolar space after facemask therapy and a follow-up period. Methods: This retrospective study was conducted between May and September in 2014. The sample consisted of pre-treatment (T1), post-treatment (T2), and follow-up(T3) panoramic radiographs of 19 skeletal and dental Class III patients (7 female, 12 male; mean age: 10.5 years) treated with facemask and a removable intraoral upper appliance in the Faculty of Dentistry Gazi University, Ankara, Turkey. Each patient’s lower arches were evaluated as right and left segments. As third molars were congenitally absent in 3 segments, a total of 35 segments were evaluated. The average treatment time was one year. The average follow-up period was 2.4 years. The positions, angulations, dental maturations of lower third molars, and mandibular retromolar spaces (DJ) were assessed. Friedman’s 2-way Analysis of Variance, multiple-comparison, Pearson’s correlation, and Chi-square tests were used for statistical evaluation. A p<0.05 was considered as significant. Results: The angulation of the first molar (¡) increased significantly only in the follow-up period (T3). Mandibular retromolar spaces were increased significantly during all periods. The most commonly determined position of the third molar, by Winter’s classification, was vertical angulation in all periods. Moderate and significant correlations were found between third molar angulation(ß) and DJ at T2 and T3. Significant correlations were also found between DJ and Demirjian classification stages during all periods. Conclusion: Facemask therapy did not have an adverse effect on the mandibular retromolar space during treatment and follow up periods.
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Affiliation(s)
- Zeynep F Zor
- Department of Orthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey. E-mail.
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