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CC BY 4.0 · Eur J Dent 2023; 17(03): 756-764
DOI: 10.1055/s-0042-1755629
Original Article

Premolar Extraction Affects Mandibular Kinematics

Alejandra Londoño 
1   Department of Research in Occlusion Medicine, Vienna School of Interdisciplinary Dentistry — VieSID, Klosterneuburg, Austria
2   Clinical Division of Prosthodontics, University Clinic of Dentistry Vienna, Medical University of Vienna, Vienna, Austria
,
Miguel Assis 
1   Department of Research in Occlusion Medicine, Vienna School of Interdisciplinary Dentistry — VieSID, Klosterneuburg, Austria
2   Clinical Division of Prosthodontics, University Clinic of Dentistry Vienna, Medical University of Vienna, Vienna, Austria
,
Cinzia Fornai 
1   Department of Research in Occlusion Medicine, Vienna School of Interdisciplinary Dentistry — VieSID, Klosterneuburg, Austria
3   Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
4   Department of Evolutionary Anthropology & Human Evolution and Archaeological Sciences (HEAS), University of Vienna, Vienna, Austria
5   Center of Clinical Research, University Clinic of Dentistry Vienna, Medical University of Vienna, Vienna, Austria
,
Markus Greven
2   Clinical Division of Prosthodontics, University Clinic of Dentistry Vienna, Medical University of Vienna, Vienna, Austria
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Abstract

Objectives The practice of premolar extraction in orthodontics is controversial for its potential detrimental effects on the stomatognathic system. However, the ways in which premolar extraction affects mandibular function are still poorly understood. The purpose of this study was to assess the influence of premolar extraction on mandibular kinematics by evaluating axiographic tracings.

Materials and Methods Forty-five orthodontically treated patients with premolar teeth extraction were compared with 45 paired untreated controls, selected for the absence of malocclusions. Systematic three-dimensional axiographic recordings of the mandibular movements were performed for protrusive–retrusive movements and speech. The transversal deviations and length of the movements were recorded for both sides along with the rotation angle during speech.

Statistical Analysis Differences between the axiographic variables were analyzed via the permutation test and Wilcoxon rank-sum test. Linear regression was performed to test whether axiographic parameters were predictive of group affiliation. Dot plots were used to explore the distribution of each of the axiographic outcomes, and isometric principal component analysis to assess the differences between the cumulative effects of premolar extraction on jaw motion.

Results The mandibular lateral translation in protrusion–retrusion and speech, the amount of rotation as well as the length of mandibular movements during speech were significantly higher in the treated subjects than in the controls, while retral stability did not differ. The linear regression yielded significant results for the mandibular lateral translation in protrusion–retrusion. The isometric principal component analysis showed higher values of the axiographic variables for 11 out of 45 individuals in the study sample compared with the control group.

Conclusions Premolar extraction altered mandibular kinematics in at least 25% of the cases within our sample, and the transversal discrepancy between protrusive and retrusive tracings was even predictive of group affiliation. These results support the notion that the routine practice of premolar extraction as part of the orthodontic treatment should be discouraged. It is compelling to perform further studies to assess whether a disrupted kinematics of the mandible is associated to temporomandibular disorders.

Keywords

jaw tracking - axiography - premolar extraction - mandibular function - orthodontic treatment - temporomandibular disorders


Publication History

Article published online:
27 September 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Bishara SE, Cummins DM, Jakobsen JR. The morphologic basis for the extraction decision in Class II, division 1 malocclusions: a comparative study. Am J Orthod Dentofacial Orthop 1995; 107 (02) 129-135
    CrossrefPubMedGoogle Scholar
  • 2 Peck S. Extractions, retention and stability: the search for orthodontic truth. Eur J Orthod 2017; 39 (02) 109-115
    CrossrefPubMedGoogle Scholar
  • 3 Dibbets JMH, van der Weele LT. Extraction, orthodontic treatment, and craniomandibular dysfunction. Am J Orthod Dentofacial Orthop 1991; 99 (03) 210-219
    CrossrefPubMedGoogle Scholar
  • 4 Erdinc AE, Nanda RS, Işiksal E. Relapse of anterior crowding in patients treated with extraction and nonextraction of premolars. Am J Orthod Dentofacial Orthop 2006; 129 (06) 775-784
    CrossrefPubMedGoogle Scholar
  • 5 Little RM, Riedel RA, Artun J. An evaluation of changes in mandibular anterior alignment from 10 to 20 years postretention. Am J Orthod Dentofacial Orthop 1988; 93 (05) 423-428
    CrossrefPubMedGoogle Scholar
  • 6 Heiser W, Stainer M, Reichegger H, Niederwanger A, Kulmer S. Axiographic findings in patients undergoing orthodontic treatment with and without premolar extractions. Eur J Orthod 2004; 26 (04) 427-433
    CrossrefPubMedGoogle Scholar
  • 7 Angle EH. Treatment of Malocclusion of the Teeth: Angle's System. 7th ed. Philadelphia, PA: S.S. White Manufacturing Co.; 1907
    Google Scholar
  • 8 Case CS. The question of extraction in orthodontia. Am J Orthod 1964; 50 (09) 660-691
    CrossrefGoogle Scholar
  • 9 Tweed CH. Indications for the extraction of teeth in orthodontic procedure. Am J Orthod Oral Surg 1944; –1945 42 (08) 22-45
    PubMedGoogle Scholar
  • 10 Begg PR. Stone age man's dentition. Am J Orthod 1954; 40 (04) 462-475
    CrossrefGoogle Scholar
  • 11 Fleming PS, Cunningham SJ, Benson PE, Jauhar P, Millett D. Extraction of premolars for orthodontic reasons on the decline? A cross-sectional survey of BOS members. J Orthod 2018; 0 (00) 1-6
    Google Scholar
  • 12 National Academies of Sciences, Engineering, and Medicine. Temporomandibular Disorders: Priorities for Research and Care. Washington, DC: National Academies Press; 2020
    Google Scholar
  • 13 O'Connor BM. Contemporary trends in orthodontic practice: a national survey. Am J Orthod Dentofacial Orthop 1993; 103 (02) 163-170
    CrossrefPubMedGoogle Scholar
  • 14 Egermark I, Carlsson GE, Magnusson T. A prospective long-term study of signs and symptoms of temporomandibular disorders in patients who received orthodontic treatment in childhood. Angle Orthod 2005; 75 (04) 645-650
    PubMedGoogle Scholar
  • 15 Leite RA, Rodrigues JF, Sakima MT, Sakima T. Relationship between temporomandibular disorders and orthodontic treatment: a literature review. Dental Press J Orthod 2013; 18 (01) 150-157
    CrossrefPubMedGoogle Scholar
  • 16 Bowbeer GR. The seventh key to facial beauty and TMJ health: proper condylar position. Part 3. Funct Orthod 1993; 10 (02) 32-34 , 36–42, 44
    PubMedGoogle Scholar
  • 17 Clark JR, Evans RD. Functional occlusal relationships in a group of post-orthodontic patients: preliminary findings. Eur J Orthod 1998; 20 (02) 103-110
    CrossrefPubMedGoogle Scholar
  • 18 Akinci Cansunar H, Uysal T. Comparison of orthodontic treatment outcomes in nonextraction, 2 maxillary premolar extraction, and 4 premolar extraction protocols with the American Board of Orthodontics objective grading system. Am J Orthod Dentofacial Orthop 2014; 145 (05) 595-602
    CrossrefPubMedGoogle Scholar
  • 19 Yoon W, Hwang S, Chung C, Kim K-H. Changes in occlusal function after extraction of premolars: 2-year follow-up. Angle Orthod 2017; 87 (05) 703-708
    CrossrefPubMedGoogle Scholar
  • 20 Khanum A, Mathew S, Naidu M, Kumar A. Extraction vs non extraction controversy: a review. J Dent Oro-facial Res 2018; 14 (01) 41-48
    Google Scholar
  • 21 Moon S, Mohamed AMA, He Y, Dong W, Yaosen C, Yang Y. Extraction vs. nonextraction on soft-tissue profile change in patients with malocclusion: a systematic review and meta-analysis. BioMed Res Int 2021; 2021: 7751516
    CrossrefPubMedGoogle Scholar
  • 22 Proffit W, Fields Jr H, Sarver D. Contemporary Orthodontics. Amsterdam: Elsevier Health Sciences; 2006
    Google Scholar
  • 23 Konstantonis D. The impact of extraction vs nonextraction treatment on soft tissue changes in class I borderline malocclusions. Angle Orthod 2012; 82 (02) 209-217
    CrossrefPubMedGoogle Scholar
  • 24 Mantout B, Giraudeau A, Perez C, Ré J-P, Orthlieb J-D. Technical validation of a computerized condylographic system. Int J Stomatol Occlusion Med 2008; 1: 45-50
    CrossrefGoogle Scholar
  • 25 Piehslinger E, Celar A, Celar R, Jäger W, Slavicek R. Reproducibility of the condylar reference position. J Orofac Pain 1993; 7 (01) 68-75
    PubMedGoogle Scholar
  • 26 Burnett CA. Mandibular incisor position for English consonant sounds. Int J Prosthodont 1999; 12 (03) 263-271
    PubMedGoogle Scholar
  • 27 Dahlberg G. Statistical Methods for Medical and Biological Students. London: George Alien and Unwin, Ltd.; 1940
    Google Scholar
  • 28 Jolicoeur P. Introduction to Biometry. Berlin: Springer Science & Business Media; 2012
    Google Scholar
  • 29 R Core Team. R: A Language and Environment for Statistical Computing. 2021. Accessed June 28, 2022 at: https://www.r-project.org/
    Google Scholar
  • 30 Suzuki K, Mito T, Ishizaki K, Sato S. Mandibular lateral translation during symmetric mandibular function in relation to patterns of intracapsular derangement of TMJ. Int J Stomatol Occlusion Med 2009; 2 (01) 16-23
    CrossrefGoogle Scholar
  • 31 Cid S, Rijpstra C, Labermeier I. Correlation of Mandibular Lateral Translation (MLT) in Symmetrical Mandibular Movements in Condylography and MRI Examination. Interdisciplinary Approach of Therapeutic Position [Master's thesis]. Vienna, Austria: Medical University of Vienna; 2012
    PubMedGoogle Scholar
  • 32 Laine T. Articulatory disorders in speech as related to size of the alveolar arches. Eur J Orthod 1986; 8 (03) 192-197
    CrossrefPubMedGoogle Scholar
  • 33 Edwards J, Harris KS. Rotation and translation of the jaw during speech. J Speech Hear Res 1990; 33 (03) 550-562
    CrossrefPubMedGoogle Scholar
  • 34 Bianchini EMG, Paiva G, de Andrade CRF. Mandibular movement patterns during speech in subjects with temporomandibular disorders and in asymptomatic individuals. Cranio 2008; 26 (01) 50-58
    CrossrefPubMedGoogle Scholar
  • 35 Akimoto S, Kubota M, Sasaguri K, Quismundo CP, Slavicek R, Sato S. Condylar movement in different skeletal frames during phonation assessed by condylography. Stomatologie 2008; 105 (01) 7-12
    CrossrefGoogle Scholar
  • 36 Dimberg L, Arnrup K, Bondemark L. The impact of malocclusion on the quality of life among children and adolescents: a systematic review of quantitative studies. Eur J Orthod 2015; 37 (03) 238-247
    CrossrefPubMedGoogle Scholar
  • 37 de Couto Nascimento V, de Castro Ferreira Conti AC, de Almeida Cardoso M, Valarelli DP, de Almeida-Pedrin RR. Impact of orthodontic treatment on self-esteem and quality of life of adult patients requiring oral rehabilitation. Angle Orthod 2016; 86 (05) 839-845
    CrossrefPubMedGoogle Scholar
  • 38 Herzog C, Konstantonis D, Konstantoni N, Eliades T. Arch-width changes in extraction vs nonextraction treatments in matched class I borderline malocclusions. Am J Orthod Dentofacial Orthop 2017; 151 (04) 735-743
    CrossrefPubMedGoogle Scholar
  • 39 Heiser W, Niederwanger A, Bancher B, Bittermann G, Neunteufel N, Kulmer S. Three-dimensional dental arch and palatal form changes after extraction and nonextraction treatment. Part 3. Transversal and sagittal palatal form. Am J Orthod Dentofacial Orthop 2004; 126 (01) 91-99
    CrossrefPubMedGoogle Scholar
  • 40 Peck CC. Biomechanics of occlusion–implications for oral rehabilitation. J Oral Rehabil 2016; 43 (03) 205-214
    CrossrefPubMedGoogle Scholar
  • 41 Shupe RJ, Mohamed SE, Christensen LV, Finger IM, Weinberg R. Effects of occlusal guidance on jaw muscle activity. J Prosthet Dent 1984; 51 (06) 811-818
    CrossrefPubMedGoogle Scholar
  • 42 Okano N, Baba K, Igarashi Y. Influence of altered occlusal guidance on masticatory muscle activity during clenching. J Oral Rehabil 2007; 34 (09) 679-684
    CrossrefPubMedGoogle Scholar