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Background: The fundamental concept of tooth movement during orthodontic treatment is the occurrence of bone remodelling accompanied by tooth movement in equal proportions. The thickness of the alveolar bone, which supports incisors, is important in estimating the direction of tooth movement. Purpose: The study aimed to measure labial and palatal alveolar bone thickness changes after maxillary incisor retraction using lateral cephalograms. Methods: Cephalograms of 40 patients (18.58 ± 4.2 years) with skeletal Class I bimaxillary protrusion after maxillary first premolar extraction for insisivus retraction had been taken before (T0) and after (T1) orthodontic treatment. Changes in alveolar bone thickness were measured in linear and angular directions and then analysed with Spearman correlative analysis. Then the samples were separated into two groups based on the type of tooth movement (tipping and torque), and then the data were analysed using Wilcoxon analysis to see differences in the bone thickness (p<0.05). Results: There was a significant difference in the apical palate (p<0.05) and a relationship between retraction and alveolar bone thickness in the midroot area. In the angular direction, there was no significant difference and relationship; however, there was a significant difference in the labial crestal in the tipping group. In the torque group, the difference in bone thickness occurred in the crestal and apical palatal areas. Conclusion: The retraction and the type of tooth movement difference influence the alveolar bone thickness.

Pendahuluan: Arnett dan Bergman (1999) membuktikan bahwa perawatan ortodonti, analisis jaringan lunak wajah, diagnosis dan rencana perawatan memiliki parameter nilai harmoni sebagai kunci penetapan estetika wajah. Perawatan maloklusi klas II skeletal disertai proganotisme maksilaris umumnya dilakukan dengan pencabutan dua premolar satu atas untuk mengkoreksi profil wajah pasien. Tujuan penelitian untuk menganalisis perubahan nilai harmoni wajah pasca perawatan maloklusi kelas II dengan pencabutan premolar satu atas menurut analisa Arnett dan Bergman. Metode: Jenis penelitian analitik observasional dengan teknik pengambilan sampel purposive sampling. Sampel penelitian 72 foto sefalometri lateral maloklusi kelas II skeletal sebelum dan setelah perawatan ortodonti. Penilaian harmoni jaringan lunak dibagi menjadi 4, yaitu harmoni intramandibular, harmoni antar rahang, orbita ke rahang dan keseimbangan wajah. Data menggunakan Shapiro Wilk menunjukkan tidak berdistribusi normal. Uji yang digunakan Shapiro Wilk dan  analisis Spearman. Hasil: Terdapat perubahan harmoni intramandibular dan keseimbangan wajah pada maloklusi kelas II skeletal dengan pencabutan premolar satu atas sebelum dan setelah perawatan (p=0,025;p=0,032). Tidak terdapat perubahan nilai harmoni antar rahang dan orbita ke rahang pada maloklusi kelas II skeletal dengan pencabutan premolar satu atas sebelum dan setelah perawatan. Ada pengaruh besar retraksi gigi insisivus terhadap nilai harmoni wajah sebelum dan setelah perawatan pada perawatan kelas II dengan pencabutan dua premolar atas (p= 0.001). Simpulan: Perawatan maloklusi kelas II skeletal dengan pencabutan dua premolar satu atas  memiliki hubungan antara besar retraksi dengan perubahan nilai harmoni wajah berdasarkan analisa Arnett dan Bergmann. Kata kunci: Maloklusi kelas II skeletal, pencabutan dua premolar pertama atas, nilai harmoni wajah. ABSTRACT Introduction: Arnett and Bergman (1999) have proved that orthodontic treatment, facial soft tissue analysis, diagnosis, and treatment plan have parameters of harmony values as the key to determining facial aesthetics. Treatment of skeletal class II malocclusion with maxillary prognathism is generally performed by extracting two maxillary first premolars to correct the patient’s facial profile. This study was aimed to analyse changes in the facial harmony values after class II malocclusion treatment with the extraction of the maxillary first premolar following Arnett and Bergman’s analysis. Methods: This research was observational analytic with a purposive sampling technique. The study sample was 72 images of skeletal class II malocclusion lateral cephalometry before and after orthodontic treatment. Assessment of soft tissue harmony was divided into four, namely intramandibular harmony, intermaxillary harmony, orbital to jaw harmony, and facial balance. Data was not normally distributed, as resulted from Shapiro Wilk analysis. The analysis in this study was conducted using Shapiro Wilk and Spearman’s analysis. Results: There were changes in intramandibular harmony and facial balance in skeletal class II malocclusion with the maxillary first premolar extraction before and after treatment (p=0.025 and p=0.032, respectively ). There was no change found in the value of intermaxillary harmony and the orbital to the jaw harmony in skeletal class II malocclusion with extraction of the maxillary first premolar before and after treatment. There was a high effect of incisor retraction on the facial harmony values before and after treatment in class II treatment with extraction of two maxillary premolars (p=0.001). Conclusion: Treatment of skeletal class II malocclusion with extraction of two maxillary first premolars has a relationship between the magnitude of retraction and changes in facial harmony values based on Arnett and Bergmann’s analysis.Keywords: Class II skeletal malocclusion, extraction of two maxillary first premolar, facial harmony.

The alveolar bone thickness influences both diagnosis and limitation of tooth movement, therefore significance retraction was commonly applied in treating patients with bimaxillary protrusion. This is a retrospective data collection of pre and post treatment lateral cephalographs from 18 to 40 years old patient treated with four premolars extraction. The alveolar mandibular bone thickness was identified in sagittal planes with Image-J software based on cephalometry lateral radiographs. Statistical analysis namely Wilcoxon test and Pearson correlation analysis coefficient were used to understand the correlation of alveolar mandibular bone thickness variables and mandibular incisors position to skeletal profile treated with first premolars extraction are presented. This data is essential for advancing in a further understanding of Class I skeletal patients with bimaxillary protrusion.

Abstract-The (17,3 %). Bridging of the sella turcica was found greater in skeletal Class III malocclusion (30.8 % of the subjects) than the skeletal Class I malocclusion (13.5 %). As conclusion, there was a significant difference between morphology of sella turcica between the skeletal Class III malocclusion and skeletal Class I malocclusion. There was also relationship between morphology of sella turcica and skeletal Class III malocclusion.