Long-term evaluation of Class II subdivision treatment with unilateral maxillary first molar extraction

Livas, Christos; Pandis, Nikolaos; Booij, Johan Willem; Katsaros, Christos; Ren, Yijin

doi:10.2319/071614-499.1

Cited by 4 publications

(6 citation statements)

References 25 publications

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“…13 The rest of the inclusion criteria were as follows: white; Class II $ 1/2 premolar width molar occlusion on one buccal segment and Class I on the contralateral segment; up to mild crowding in the mandibular arch; full complement of permanent teeth; and panoramic radiographs of good quality obtained pretreatment (T1), posttreatment (T2), and at a minimum follow-up period (T3) of 1.8 years (mean follow-up, 2.6 years; SD, 1.0 years) ( Table 1). The right maxillary M1 was extracted in 14 subjects, whereas the left M1 was extracted in seven of the cases.…”

Section: Methodsmentioning

confidence: 99%

Influence of unilateral maxillary first molar extraction treatment on second and third molar inclination in Class II subdivision patients

Livas

Pandis

Booij

et al. 2015

The Angle Orthodontist

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Objective: To assess the maxillary second molar (M2) and third molar (M3) inclination following orthodontic treatment of Class II subdivision malocclusion with unilateral maxillary first molar (M1) extraction. Materials and Methods: Panoramic radiographs of 21 Class II subdivision adolescents (eight boys, 13 girls; mean age, 12.8 years; standard deviation, 1.7 years) before treatment, after treatment with extraction of one maxillary first molar and Begg appliances and after at least 1.8 years in retention were retrospectively collected from a private practice. M2 and M3 inclination angles (M2/ITP, M2/IOP, M3/ITP, M3/IOP), constructed by intertuberosity (ITP) and interorbital planes (IOP), were calculated for the extracted and nonextracted segments. Random effects regression analysis was performed to evaluate the effect on the molar angulation of extraction, time, and gender after adjusting for baseline measurements. Results: Time and extraction status were significant predictors for M2 angulation. M2/ITP and M2/ IOP decreased by 4.04 (95% confidence interval [CI]: 26.93, 1.16; P 5 .001) and 3.67 (95% CI: 26.76, 20.58; P 5 .020) in the extraction group compared to the nonextraction group after adjusting for time and gender. The adjusted analysis showed that extraction was the only predictor for M3 angulation that reached statistical significance. M3 mesial inclination increased by 7.38u (95% CI: 211.2, 23.54; P , .001) and 7.33u (95% CI: 211.48, 23.19; P 5 .001). Conclusions: M2 and M3 uprighting significantly improved in the extraction side after orthodontic treatment with unilateral maxillary M1 extraction. There was a significant increase in mesial tipping of maxillary second molar crowns over time. (Angle Orthod. 2016;86:94-100.)

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Section: Methodsmentioning

confidence: 99%

Influence of unilateral maxillary first molar extraction treatment on second and third molar inclination in Class II subdivision patients

Livas

Pandis

Booij

et al. 2015

The Angle Orthodontist

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“…[4] Regarding molar extraction in the correction of Class II subdivision, the unilateral extraction of the first maxillary molar followed by the fixed orthodontic appliance has been a successful proposed therapy. [7] This approach presents good long-term occlusal results and low impact on posttreatment outcomes in what concerns to dental midlines and to the esthetic of the facial soft tissues. In this case, we registered a slight relapse of 1 mm in the mandibular midline without any aesthetic and functional harm, during 3 years of follow-up.…”

Section: Discussionmentioning

confidence: 99%

Rethink the Malocclusion of Class II Subdivision

Aguiar

Castro

Moreira

et al. 2018

J Indian Orthod Soc

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The treatment of the Class II subdivision presents a real challenge in orthodontics, and a lot of discussions are created around it with one important question: What is the best treatment option? We report one young female Patient with Class II subdivision malocclusion treated with an asymmetric extraction of the first permanent maxillary molar on the side of the distoclusion. In this case, we take advantage of the space created from the extraction site to correct the distoclusion and substitute the first molar with the second molar, and by preserving the third molar, we substitute the second maxillary permanent molar with this tooth. The results reveal a good vertical control, Class I molar and Class I canine was achieved accompanied by a correct alignment and leveling of the maxillary and mandibular arches. With this approach, we can respect the geometry of the arch without esthetic damage, functional problems at the level of the temporomandibular joint, keeping all the correct occlusal relationships and guides of dynamics associated with correct arch shape and clear harmony in the excursive movements. It is clinically justifiable to strive for an orthodontic result that respects the spherical functionality proposed by Slavicek.

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“…Our Class II subdivision technique led to good occlusal and esthetic outcomes, which were preserved for 4 years after active treatment had been completed. Besides stable end results in the long term [ 6 ], a positive effect on the axial inclination of maxillary third molars was demonstrated in Class II subdivision cases treated with unilateral maxillary first molar extraction and low friction fixed appliances [ 7 ]. Maxillary third molars in the extraction side became 3.1–3.4 times more upright than the contralateral teeth [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Longer treatment duration has been observed in asymmetric premolar extraction protocols [ 4 , 5 ] compared to orthodontic therapy with either unilateral maxillary first molar extraction [ 6 ] or Herbst and fixed appliances [ 3 ]. Nonetheless, with respect to the end molar occlusion, Class III in the original Class I side may be expected in Class II subdivision patients treated with fixed functional appliances [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

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Unilateral Maxillary First Molar Extraction in Class II Subdivision: An Unconventional Treatment Alternative

Booij

Livas

2016

Case Reports in Dentistry

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The asymmetrical intra-arch relationship in Class II subdivision malocclusion poses challenges in the treatment planning and mechanotherapy of such cases. This case report demonstrates a treatment technique engaging unilateral extraction of a maxillary first molar and Begg fixed appliances. The outcome stability and the enhancing effect on the eruption of the third molar in the extraction segment were confirmed by a 4-year follow-up examination.

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Long-term evaluation of Class II subdivision treatment with unilateral maxillary first molar extraction

Abstract: Unilateral M1 extraction in asymmetrical Class II cases may lead to favorable occlusal outcomes in the long term without harming the midline esthetics and soft tissue profile.

Cited by 4 publications

References 25 publications

Influence of unilateral maxillary first molar extraction treatment on second and third molar inclination in Class II subdivision patients

Influence of unilateral maxillary first molar extraction treatment on second and third molar inclination in Class II subdivision patients

Rethink the Malocclusion of Class II Subdivision

Unilateral Maxillary First Molar Extraction in Class II Subdivision: An Unconventional Treatment Alternative

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