The esthetic profile preferences of Class II malocclusion patients treated with extraction or non-extraction

Abstract

The treatment of Class II can have a positive or a negative impact on the facial profile aesthetic. The present study aims to evaluate the impact of two methods of orthodontic treatment of Class II malocclusion on the facial profile aesthetics. The facial profiles of 46 patients with Class II malocclusion were outlined by radiography before and after treatment; 23 of the patients were treated by the extraction of two maxillary first premolars (EXT group), and the other 23, with the Thurow Appliance (TA group), followed by braces. The profile silhouettes were filled in using the Corel Draw program. An album containing the patient’s silhouettes of both groups was created randomly, with two profiles of a patient per page. The preferences of 30 orthodontists, 30 dentists, and 30 laypersons in relation to the profile were recorded along with their perceived differences between the pre-treatment and post-treatment profiles, according to the visual analog scale. All groups of evaluators preferred the post-treatment profile more frequently. There were statistically significant differences in the evaluators’ preferences only between the orthodontists’ and the laypersons’ groups. None of the evaluators’ groups indicated substantial differences between the pre-treatment and post-treatment profiles. It may be concluded that both Class II treatment protocols, i.e., the double-extraction of the first premolars and the use of TA, improved the patients’ facial profile aesthetics.Keywords: Face. Malocclusion, Angle Class II. Tooth Extraction.Resumo As modalidades de tratamentos da Classe II tem um impacto sobre a estética da face que pode ser positivo ou negativo. O objetivo deste estudo foi avaliar o impacto da estética do perfil facial decorrente de dois tipos de tratamento para a Classe II. Foram traçados os perfis faciais das telerradiografias pré e pós-tratamento de 46 pacientes Classe II, sendo 23 de um grupo tratado com extração de dois primeiros pré-molares superiores e 23 de um grupo tratado com AEB Conjugado seguido de aparelho fixo, e estes traçados foram preenchidos com o programa Corel Draw. Foi montado um álbum com as silhuetas dos pacientes (AEB e EXO) de forma aleatória, sendo dois perfis em cada folha do mesmo paciente. Foi pedido para 30 ortodontistas, 30 cirurgiões-dentistas e 30 leigos para verificarem a sua preferência em relação ao perfil e a quantidade de diferença entre os perfis pré e pós-tratamento, de acordo com a escala analógica visual. Os 3 grupos de avaliadores preferiram o perfil pós-tratamento com maior frequência. Houve diferenças estatisticamente significantes somente entre os grupos de avaliadores ortodontistas e leigos; os 3 grupos de avaliadores indicaram que os perfis pré e pós-tratamento, não diferiram substancialmente. Pode-se concluir que o tratamento da Classe II, com extração de dois primeiros pré-molares, e com o uso do aparelho AEB Conjugado produziu um impacto positivo na estética do perfil.Palavras-chave: Face. Má Oclusão de Angle Classe II. Extração Dentária.

Evaluation of Facial Profile Pleasantness in Patients with Class II Malocclusion Treated with Intermaxillary Elastics

“…Such result might be considered surprising since the intermaxillary elastic biomechanic effects are restricted to the dentoalveolar area. Despite that, an improvement in the facial profile was observed as well as in studies that asses esthetic facial impact from orthopedic treatment 17,29 or with teeth extraction 21,28 . These results became easier to understand after a search was performed in the regarding which facial characteristics have impacted more in the facial esthetic assessment.…”

“…Thank to that, facial aspects that must be taken into consideration like the nose size and shape r the interlabial gap are highlighted. 1,22,23,27 Several quantifying methods can be used to assess the pre and post-treatment facial pleasantness such as visual analogue scale (VAS) 1,25,28 the implicit association test (IAT) 7 or a Likert scale from 0 to 10 24 to evaluate or quantify the facial changes. However, in the present study the 5-point Likert scale was chosen.…”

“…However, in the present study the 5-point Likert scale was chosen. This method, well acknowledged in the literature, was used in a previous study [26][27][28] due to its simple and fast application, being easily understood by the examiners.…”

Cambios faciales por exodoncias de primeros premolares maxilares, maloclusiones Clase II subdivisión 1: Revisión narrativa

“…Se estima que la maloclusión Clase II subdivisión 1 en la ciudad de Cuenca corresponde a un 30,04% (Coello-Vásquez et al, 2018). Uno de los procedimientos que se muestra como efectivo para tratar la maloclusión Clase II subdivisión 1 son las extracciones de los primeros premolares superiores, el mismo que puede provocar cambios en el perfil facial; lo cual la convierte en uno de los temas más estudiados en la ortodoncia contemporánea por su complejidad e incidencia (Trecenti et al, 2018).…”

“…(Janson et al, 2016;Janson et al, 2018;Zierhut et al, 2000). Luego de realizar las extracciones de los primeros premolares superiores se necesita la retracción de los incisivos superiores, implicando a que los labios acompañen este desplazamiento provocando cambios en el perfil facial sobre todo de manera sagital; es por eso que corresponde al ortodoncista dictaminar el tratamiento que brindará los mejores resultados funcionales y estéticos para el paciente (Trecenti et al, 2018).…”