Dental and Medical Problems
2020, vol. 57, nr 3, July-September, p. 275–283
Publication type: original article
Extraction versus non-extraction orthodontic treatment: Soft tissue profile changes in borderline class I patients
Ekstrakcyjne a nieekstrakcyjne leczenie ortodontyczne – zmiany profilu tkanek miękkich u pacjentów z wątpliwą klasą I
1 Department of Orthodontics, Dental Research Center, Hamadan University of Medical Sciences, Iran
2 Private practice, Hamadan, Iran
3 Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Iran
4 Department of Orthodontics, Faculty of Dentistry, Hamadan University of Medical Sciences, Iran
5 Department of Oral and Maxillofacial Surgery, Implant Research Center, Hamadan University of Medical Sciences, Iran
Background. The decision regarding the selection of extraction or non-extraction orthodontic treatment is a common challenge in orthodontic treatment planning.
Objectives. The objective of this study was to compare the effects of extraction and non-extraction orthodontic treatment on the soft tissue profile of borderline class I patients.
Material and Methods. In this retrospective study, 70 patients were selected from among those referred to the Department of Orthodontics of the Faculty of Dentistry at Hamadan University of Medical Sciences in Iran. The inclusion criteria were skeletal class I, 4–10 mm of space deficiency, and the possibility of applying both extraction and non-extraction orthodontic treatment. All patients underwent fixed orthodontic treatment with the use of 0.022-inch-slot edgewise brackets. The patients were divided into 2 groups (n = 35) according to the 4-premolar extraction or non-extraction treatment plan. The 2 groups were compared by means of the cephalometric analysis.
Results. There were 11 males and 24 females at a mean age of 17.46 years in the non-extraction group, and 9 males and 26 females at a mean age of 18.46 years in the extraction group. The upper and lower incisors as well as the lower lip moved forward in the non-extraction group (lower lip to E‑plane = 0.87 ±1.39 mm, U1–SN = 2.83 ±8.03°, IMPA = 4.64 ±5.47°). The incisors and the lips moved backward in the extraction group (upper lip to E‑plane = −1.42 ±2.08 mm, lower lip to E‑plane = −1.56 ±1.97 mm, U1–SN = −7.63 ±9.02°, IMPA = −7.05 ±6.79°). The differences were statistically significant (p < 0.05). Mentolabial sulcus became more pronounced in the non-extraction group (1.92 ±2.73 mm; p < 0.001) and shallower in the extraction group (−1.90 ±4.2 mm; p = 0.000).
Conclusion. Orthodontic treatment can change the soft tissue appearance of the lower third of the face. The lips and the incisors moved forward in the non-extraction group and backward in the extraction group.
tooth extraction, orthodontics, cephalometry, Angle class I malocclusion
ekstrakcja zęba, ortodoncja, cefalometria, wada zgryzu klasy I wg Angle’a
- Amirabadi GE, Mirzaie M, Kushki SM, Olyaee P. Cephalometric evaluation of soft tissue changes after extraction of upper first premolars in class ΙΙ div 1 patients. J Clin Exp Dent. 2014;6(5):e539–e545.
- Maple JR, Vig KWL, Beck FM, Larsen PE, Shanker S. A comparison of providers’ and consumers’ perceptions of facial-profile attractiveness. Am J Orthod Dentofacial Orthop. 2005;128(6):690–696, quiz 801.
- Soh J, Chew MT, Wong HB. A comparative assessment of the perception of Chinese facial profile esthetics. Am J Orthod Dentofacial Orthop. 2005;127(6):692–699.
- Wilmot JJ, Barber HD, Chou DG, Vig KW. Associations between severity of dentofacial deformity and motivation for orthodontic-orthognathic surgery treatment. Angle Orthod. 1993;63(4):283–288.
- Verma SL, Sharma VP, Tandon P, Singh GP, Sachan K. Comparison of esthetic outcome after extraction or non-extraction orthodontic treatment in class II division 1 malocclusion patients. Contemp Clin Dent. 2013;4(2):206–212.
- Kachiwala VA, Kalha AS, Machado G. Soft tissue changes associated with first premolar extractions in adult females. Aust Orthod J. 2009;25(1):24–29.
- Leonardi R, Annunziata A, Licciardello V, Barbato E. Soft tissue changes following the extraction of premolars in nongrowing patients with bimaxillary protrusion: A systematic review. Angle Orthod. 2010;80(1):211–216.
- Zarringhalam M, Arash V. Labial changes following extraction of first premolars for orthodontic treatment in patients with malocclusion class II Div I [in Persian]. J Mashhad Dent School. 2003;27(3,4):126–133.
- Erdinc AE, Nanda RS, Dandajena TC. Profile changes of patients treated with and without premolar extractions. Am J Orthod Dentofacial Orthop. 2007;132(3):324–331.
- Bishara SE, Jakobsen JR. Profile changes in patients treated with and without extractions: Assessments by lay people. Am J Orthod Dentofacial Orthop. 1997;112(6):639–644.
- Hazar S, Akyalçin S, Boyacioğlu H. Soft tissue profile changes in Anatolian Turkish girls and boys following orthodontic treatment with and without extractions. Turk J Med Sci. 2004;34(3):171–178.
- Lai J, Ghosh J, Nanda RS. Effects of orthodontic therapy on the facial profile in long and short vertical facial patterns. Am J Orthod Dentofacial Orthop. 2000;118(5):505–513.
- Paquette DE, Beattie JR, Johnston LE Jr. A long-term comparison of nonextraction and premolar extraction edgewise therapy in “borderline” Class II patients. Am J Orthod Dentofacial Orthop. 1992;102(1):1–14.
- Basciftci FA, Usumez S. Effects of extraction and nonextraction treatment on class I and class II subjects. Angle Orthod. 2003;73(1):36–42.
- Momeni Danaei S, Salehi P, Zareh A, Keshavarz M. Soft tissue and dentoskeletal changes in class II division 1 patients following extraction and non-extraction treatment [in Persian]. J Dent. 2005;6(1,2):128–138.
- Xu TM, Liu Y, Huang W, Lin JX. Cephalometric comparison of soft-tissue morphology between extraction and non-extraction orthodontic treatment in borderline cases [in Chinese]. Beijing Da Xue Xue Bao Yi Xue Ban. 2004;36(6):650–654.
- Xu TM, Liu Y, Yang MZ, Huang W. Comparison of extraction versus nonextraction orthodontic treatment outcomes for borderline Chinese patients. Am J Orthod Dentofacial Orthop. 2006;129(5):672–677.
- Bravo LA. Soft tissue facial profile changes after orthodontic treatment with four premolars extracted. Angle Orthod. 1994;64(1):31–42.
- Bishara SE, Cummins DM, Jakobsen JR, Zaher AR. Dentofacial and soft tissue changes in Class II, division 1 cases treated with and without extractions. Am J Orthod Dentofacial Orthop. 1995;107(1):28–37.
- Talass MF, Talass L, Baker RC. Soft-tissue profile changes resulting from retraction of maxillary incisors. Am J Orthod Dentofacial Orthop. 1987;91(5):385–394.
- Lo FD, Hunter WS. Changes in nasolabial angle related to maxillary incisor retraction. Am J Orthod. 1982;82(5):384–391.
- Diels RM, Kalra V, DeLoach N Jr., Powers M, Nelson SS. Changes in soft tissue profile of African-Americans following extraction treatment. Angle Orthod. 1995;65(4):285–292.
- Al-Abdwani R, Moles DR, Noar JH. Changes of incisor inclination effects on point A and B. Angle Orthod. 2009;79(3):462–467.
- Fitzgerald JP, Nanda RS, Currier GF. An evaluation of the nasolabial angle and the relative inclinations of the nose and upper lip. Am J Orthod Dentofacial Orthop. 1992;102(4):328–334.
- Shirvani A, Sadeghian S, Abbasi S. Prediction of lip response to orthodontic treatment using a multivariable regression model. Dent Res J (Isfahan). 2016;13(1):38–45.
- Oliver BM. The influence of lip thickness and strain on upper lip response to incisor retraction. Am J Orthod. 1982;82(2):141–149.
- Bloom LA. Perioral profile changes in orthodontic treatment. Am J Orthod Dentofacial Orthop. 1961;47(5):371–379.