Document Type : Original Article

Authors

1 Assistant professor of Orthodontics, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran

2 Post graduate student, Department of Orthodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran

3 Undergraduate Student of Dentistry, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran

10.22034/ijo.2021.542723.1006

Abstract

Background: There is a continuous debate on the issue of comparison between extraction and non-extraction treatment results in terms of subsequent soft tissue changes for Class II division 1 patients. So far, however, far too little attention has been paid to photographic evaluation of treatment results.
Aims: The aim of this was to assess the impact of extraction and non-extraction treatment of Class II division 1malocclusion on soft tissue profile by means of pre- and post- treatment photographs.
Materials and methods: The pre- and post- treatment profile photographs of 41 borderline Class II division 1malocclusion patients (ANB ≤5 degrees, and overjet ≤ 5 mm) were evaluated. The photographs were digitized into the computer and 19 angular measurements were evaluated. Paired t-tests and Independent-sample t-tests were performed to compare the pre- and post- treatment values between the extraction and non- extraction groups. The level of significance was set to be P < .05.
Results: Significant differences between pre- and post- treatment values in extraction group existed for Z angle and N‑Sn‑Pog. In non- extraction group significant differences observed in N‑Pn‑Pog, G‑Sn‑Pog, N‑Sn‑Pog and N‑Sn‑B.When comparing the extraction and non-extraction groups before and after treatment the results showed that the only significant difference was in PFH/AFH proportion.
Conclusions: The results of this study for both extraction and non- extraction group were straightening and improvement of soft tissue profile without significant impact on lips or nasolabial angle.

Keywords

Main Subjects

  1. Oliveira PG, Tavares RR, Freitas JC. Assessment of motivation, expectations and satisfaction of adult patients submitted to orthodontic treatment. Dental press journal of orthodontics. 2013;18:81-7. doi: 10.1590/s2176 94512013000200018.
  2. Samsonyanová L, Broukal Z. A systematic review of individual motivational factors in orthodontic treatment: facial attractiveness as the main motivational factor in orthodontic treatment. International journal of dentistry. 2014 May 20;2014. doi: 10.1155/2014/938274.
  3. Al Taki A, Guidoum A. Facial profile preferences, self-awareness and perception among groups of people in the United Arab Emirates. Journal of orthodontic science. 2014 Apr;3(2):55. doi: 10.4103/2278-0203.132921.
  4. Dhiman S, Maheshwari S. A dilemma in orthodontics: Extractions in borderline cases. Journal of Advanced Clinical and Research Insights. 2015;2(1):36-9. doi:10.15713/ins.jcri.40.
  5. Almurtadha RH, Alhammadi MS, Fayed MM, AbouEl-Ezz A, Halboub E. Changes in soft tissue profile after orthodontic treatment with and without extraction: A systematic review and meta-analysis. Journal of Evidence Based Dental Practice. 2018 Sep 1;18(3):193-202. doi: 10.1016/j.jebdp.2017.09.002.
  6. Ackerman JL, Proffit WR, Sarver DM. The emerging soft tissue paradigm in orthodontic diagnosis and treatment planning. Clinical orthodontics and research. 1999 May;2(2):49-52. doi: 10.1111/ocr.1999.2.2.49.
  7. Burstone CJ. The integumental profile. American journal of orthodontics. 1958 Jan 1;44(1):1-25.
  8. Park YC, Burstone CJ. Soft-tissue profile-fallacies of hard-tissue standards in treatment planning. American Journal of Orthodontics and Dentofacial Orthopedics. 1986 Jul 1;90(1):52-62. doi: 10.1016/0889-5406(86)90027-2.
  9. Fernández‐Riveiro P, Smyth‐Chamosa E, Suárez‐ Quintanilla D, Suárez‐Cunqueiro M. Angular photogrammetric analysis of the soft tissue facial profile. The European Journal of Orthodontics. 2003 Aug 1;25(4):393-9. doi: 10.1093/ejo/25.4.393.
  10. Malkoç S, Demir A, Uysal T, Canbuldu N. Angular photogrammetric analysis of the soft tissue facial profile of Turkish adults. The European Journal of Orthodontics. 2009 Apr 1;31(2):174-9. doi: 10.1093/ejo/cjn082.
  11. de Carvalho Rosas Gomes L, Horta KO, Gandini Jr LG, Gonçalves M, Gonçalves JR. Photographic assessment of cephalometric measurements. The Angle Orthodontist. 2013 Nov;83(6):1049-58. doi: 10.2319/120712-925.1.
  12. Aksakalli S, Demir A. Facial soft tissue changes after orthodontic treatment. Nigerian journal of clinical practice. 2014 May 28;17(3):282-6. doi: 10.4103/1119-3077.130226.
  13. Janson G, Fuziy A, de Freitas MR, Henriques JF, de Almeida RR. Soft-tissue treatment changes in Class II Division 1 malocclusion with and without extraction of maxillary premolars. American journal of orthodontics. doi: 10.1016/j.ajodo.2007.05.012.
  14. Verma SL, Sharma VP, Singh GP, Sachan K. Comparative assessment of soft-tissue changes in Class II Division 1 patients following extraction and non-extraction treatment. Dental Research Journal. 2013 Nov;10(6):764. PMID: 24379865.
  15. Janson G, Mendes LM, Junqueira CH, Garib DG. Soft-tissue changes in Class II malocclusion patients treated with extractions: a systematic review. European journal of orthodontics. 2016 Dec 1;38(6):631-7. doi: 10.1093/ejo/cjv083.
  16. Bishara SE, Cummins DM, Jakobsen JR, Zaher AR. Dentofacial and soft tissue changes in Class II, division 1 cases treated with and without extractions. American Journal of Orthodontics and Dentofacial Orthopedics. 1995 Jan 1;107(1):28- 37. doi: 10.1016/s0889-5406(95)70154-0.
  17. Combrink FJ, Harris AM, Steyn CL, Hudson AP. Dentoskeletal and soft-tissue changes in growing class II malocclusion patients during nonextraction orthodontic treatment. SADJ. 2006 Sep;61(8):344-50. PMID: 17165248.
  18. Janson G, Lenza EB, Francisco R, Aliaga-Del Castillo A, Garib D, Lenza MA. Dentoskeletal and soft tissue changes in class II subdivision treatment with asymmetric extraction protocols. Progress in orthodontics. 2017 Dec;18(1):1-0. doi: 10.1186/s40510- 017-0193-x.
  19. Drobocky OB, Smith RJ. Changes in facial profile during orthodontic treatment with extraction of four first premolars. American Journal of Orthodontics and Dentofacial Orthopedics. 1989 Mar 1;95(3):220-30. doi: 10.1016/0889- 5406(89)90052-8.
  20. Paquette DE, Beattie JR, Johnston Jr LE. A long-term comparison of nonextraction and premolar extraction edgewise therapy in “borderline” Class II patients. American Journal of Orthodontics and Dentofacial Orthopedics. 1992 Jul 1;102(1):1-4. doi: 10.1016/0889-5406(92)70009-Y.
  21. Young TM, Smith RJ. Effects of orthodontics on the facial profile: a comparison of changes during nonextraction and four premolar extraction treatment. American Journal of Orthodontics and Dentofacial Orthopedics. 1993 May 1;103(5):452-8. doi: 10.1016/S0889-5406(05)81796-2.
  22. Bishara SE, Cummins DM, Jakobsen JR, Zaher AR. Dentofacial and soft tissue changes in Class II, division 1 cases treated with and without extractions. American Journal of Orthodontics and Dentofacial Orthopedics. 1995 Jan 1;107(1):28- 37. doi: 10.1016/s0889-5406(95)70154-0.
  23. James RD. A comparative study of facial profiles in extraction and nonextraction treatment. American journal of orthodontics and dentofacial orthopedics. 1998 Sep 1;114(3):265-76. doi: 10.1016/s0889-5406(98)70208-2.
  24. Saelens NA, De Smit AA. Therapeutic changes in extraction versus non-extraction orthodontic treatment. The European Journal of Orthodontics. 1998 Jun 1;20(3):225-36. doi: 10.1093/ejo/20.3.225.
  25. Finnöy JP, Wisth PJ, Böe OE. Changes in soft tissue profile during and after orthodontic treatment. The European Journal of Orthodontics. 1987 Jan 1;9(1):68-78. doi: 10.1093/ejo/9.1.68.
  26. Looi LK, Mills JR. The effect of two contrasting forms of orthodontic treatment on the facial profile. American Journal of Orthodontics. 1986 Jun 1;89(6):507-17. doi: 10.1016/0002-9416(86)90009- 6.
  27. Al-Sibaie S, Hajeer MY. Assessment of changes following en-masse retraction with mini-implants anchorage compared to two-step retraction with conventional anchorage in patients with class II division 1 malocclusion: a randomized controlled trial. European journal of orthodontics. 2014 Jun 1;36(3):275-83. doi: 10.1093/ejo/cjt046.
  28. Upadhyay M, Yadav S, Nagaraj K, Uribe F, Nanda R. Mini-implants vs fixed functional appliances for treatment of young adult Class II female patients: a prospective clinical trial. The Angle Orthodontist. 2012 Mar;82(2):294-303. doi: 10.2319/042811-302.1.
  29. Rains MD, Nanda R. Soft-tissue changes associated with maxillary incisor retraction. American journal of orthodontics. 1982 Jun 1;81(6):481-8. doi: 10.1016/0002-9416(82)90427-4.
  30. Hershey HG. Incisor tooth retraction and subsequent profile change in postadolescent female patients. American Journal of Orthodontics. 1972 Jan 1;61(1):45-54. doi: 10.1016/0002-9416(72)90175-3.
  31. Xu TM, Liu Y, Yang MZ, Huang W. Comparison of extraction versus nonextraction orthodontic treatment outcomes for borderline Chinese patients. American journal of orthodontics and dentofacial orthopedics. 2006 May 1;129(5):672-7. doi: 10.1016/j.ajodo.2005.12.007.
  32. Statistical Methods for Medical and Biological Students. Br Med J. 1940 Sep 14;2(4158):358–9. PMCID: PMC2179091.