Airway and Cephalometric Changes in Adult Orthodontic Patients After Premolar Extractions

Abstract

Objective: To examine changes in the airway and cephalometric measurements associated with orthodontic treatment of adults with and without premolar extractions. The study investigated whether extractions had a direct or indirect effect on the airway and examined selected skeletal and dental features. Materials and Methods: This retrospective study used pre- (T1) and posttreatment (T2) cone-beam computed tomography scans of 83 adult patients matched for age and sex. A total of 15 airway and 10 skeletal and dental measures were analyzed by means of repeated-measures analysis of variance. Results: There were no results showing that extractions affected airway dimensions that could not be accounted for as reflections of measurement error. There was no evidence that extractions affected the airway indirectly through skeletal and dental changes. There were strong and consistent findings that patients with small airways showed larger ones after treatment and that patients with large airways showed smaller ones later. These effects were independent of whether or not extractions were part of treatment. The measurement phenomena of regression toward the mean and of differential unfolding of natural changes over time could have accounted for the results observed. Conclusions: There was no evidence that extractions in nongrowing patients have negative consequences on the size of various airway measures in the nasopharynx, retropalatal, or retroglossal regions.

Effects of Four First Premolar Extraction on the Upper Airway Dimension in a NonGrowing Class I Skeletal Patients: A Systematic Review

“…Thirty-three articles were then selected for full-text assessment. After the full-text appraisal, 26 articles were excluded due to the following reasons: Article in a different language [30], sample age below 16 years old [24,[31][32][33][34], Different premolar extractions [35,36], Different anchorage designs [25,[37][38][39][40][41][42][43], Different malocclusion [44], Nonretrospective studies [16,19,22,[45][46][47][48][49][50]. Six eligible retrospective study articles were selected in this systematic review [20,22,23,[51][52][53].…”

“…Valiathan et al [24], Pliska et al [26] and Joy et al [37], concluded a negative association between airway space changes and dental extractions.…”

Effect of Craniofacial Morphology on Pharyngeal Airway Volume Measured Using Cone-Beam Computed Tomography (CBCT)—A Retrospective Pilot Study

“…In a study conducted by Joy et al [ 30 ] Pliska et al [ 31 ] and Zhang et al [ 32 ], the relationship between extraction of premolars and changes in airway dimensions were noted during orthodontic treatment. They stated that dental extractions affect dental features such as upper and lower incisor position and inclinations and intermolar width.…”

A community detection analysis of malocclusion classes from orthodontics and upper airway data

“…3 Different aspects were analysed by other authors: effects produced by conventional fixed appliance therapy and/or orthognathic surgery, effects produced by extractive treatments and outcomes generated by functional appliance therapy. [4][5][6][7][8][9][10] Among them, a special interest was devoted to the possible relationships between airway dimensions and different anteroposterior facial patterns. [11][12][13][14][15][16][17][18] The interest in elucidating these relationships is not new: airway and the naso-respiratory function have been in the centre of interest among orthodontists since the seventies.…”

“…Back in 2012, Van Vlijmen, based on the then‐available evidence, could claim that only the studies assessing airway diagnostics showed a scientific impact of CBCT in the orthodontic field 3 . Different aspects were analysed by other authors: effects produced by conventional fixed appliance therapy and/or orthognathic surgery, effects produced by extractive treatments and outcomes generated by functional appliance therapy 4‐10 . Among them, a special interest was devoted to the possible relationships between airway dimensions and different anteroposterior facial patterns 11‐18 .…”