Effect of orthodontic treatment with 4 premolar extractions compared with nonextraction treatment on the vertical dimension of the face: A systematic review.

Introduction: Our aim was to assess the available evidence for the effects of orthodontic treatment with 4 premolar extractions on the skeletal vertical dimension of the face compared with nonextraction treatment.Methods: Electronic database searches (MEDLINE, EMBASE, Cochrane Oral Health Group's Tr...

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Published in:American Journal of Orthodontics & Dentofacial Orthopedics Vol. 154; no. 2; pp. 175 - 188
Main Authors: Kouvelis, Georgios, Dritsas, Konstantinos, Doulis, Ioannis, Kloukos, Dimitrios, Gkantidis, Nikolaos
Format: research systematic review Journal Article
Published: Elsevier B.V. Aug2018
Online Access:View this record in EBSCOhost
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      dt: Aug2018
      vid: 154
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      pub: Elsevier B.V.
      place: New York, New York
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        10.1016/j.ajodo.2018.03.007
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        atl: Effect of orthodontic treatment with 4 premolar extractions compared with nonextraction treatment on the vertical dimension of the face: A systematic review.
      aug:
        au:
          Kouvelis, Georgios
          Dritsas, Konstantinos
          Doulis, Ioannis
          Kloukos, Dimitrios
          Gkantidis, Nikolaos
        affil: Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force Hospital, Athens, Greece
      sug:
        subj:
          Dental Occlusion
          Orthodontics, Corrective Methods
          Face Anatomy and Histology
          Bicuspid Surgery
          Serial Extraction
          Human
          Systematic Review
      ab: Introduction: Our aim was to assess the available evidence for the effects of orthodontic treatment with 4 premolar extractions on the skeletal vertical dimension of the face compared with nonextraction treatment.Methods: Electronic database searches (MEDLINE, EMBASE, Cochrane Oral Health Group's Trials Register, and CENTRAL) of published and unpublished literature and hand searches of eligible studies were performed, with no language or publication date restrictions. Two authors performed data extraction independently and in duplicate. Risk of bias was assessed.Results: After application of the eligibility criteria, 14 studies were included in this systematic review. All were retrospective. Risk of bias ranged from moderate to critical. Ten studies investigated patients with various skeletal vertical patterns and classes of malocclusion and found no difference between extraction (Ex) and nonextraction (Nonex) treatment in regard to the vertical dimension. Only 2 studies found statistically significant increases in the nonextraction groups, one in N-Me (Ex: +1.5 mm; Nonex: +5.5 mm; P <0.05) and one in SN-GoGn (Ex: -0.9°; Nonex: +0.8°; P <0.05), but without a concurrent significant change in other vertical measurements such as FMA. Two other studies showed opposite findings regarding N-Me (Ex: +2.3 mm; Nonex: +0.9 mm; P <0.05) and FMA (Ex: +0.3°; Nonex: -2.0°; P <0.05).Conclusions: Although the quality of evidence ranged from moderate to low, there was considerable agreement among these studies, suggesting that orthodontic treatment with 4 premolar extractions has no specific effect on the skeletal vertical dimension. Thus, an extraction treatment protocol aiming to reduce or control the vertical dimension does not seem to be an evidence-based clinical approach.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        Journal Article
      ougenre: Article
    language: English
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