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Quinzi V, Salvati SE, Lerda F, Compri M, Rosa M, Primozic J. Skeletal and dental effects of serial extractions performed with or without maxillary expansion-A retrospective controlled study. Orthod Craniofac Res 2023; 26:642-649. [PMID: 36905088 DOI: 10.1111/ocr.12647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVES The study aimed to compare severe crowding treatment's skeletal and dental effects by serial extractions or maxillary expansion and serial extractions in the mixed dentition phase. SETTING AND SAMPLE POPULATION The retrospective controlled study included lateral cephalograms of 78 subjects aged 8.5 ± 1.4 years, 52 consecutively treated because of severe crowding, and 26 untreated controls matched for baseline age and observational period. METHODS Subjects were clustered according to the treatment modality, either serial extraction (EX) or expansion and extraction (EXP-EX) group. Sagittal and vertical skeletal as well as dental cephalometric parameters were assessed at baseline and after the eruption of all permanent posterior teeth, and group comparisons were performed. RESULTS Both treatment modalities significantly affected the vertical skeletal parameters in terms of decreasing the mandibular and occlusal plane inclination and increasing the facial height index. A distinct treatment effect on the gonial angle was observed, with a significant decrease in its superior part observed in both extraction groups. The annualized changes in the superior part of the gonial angle significantly differ (P = .036) between the Control (-0.04 ± 0.6), EX (-0.44 ± 0.6) and EXP-EX (-0.34 ± 0.5) groups. Upper and lower incisor inclination did not change significantly in any of the groups; however, the interincisal angle at follow-up was significantly smaller in the Control compared with both treated groups. CONCLUSIONS Serial extractions and a combination of maxillary expansion and serial extractions have similar significant skeletal effects, mainly affecting vertical cephalometric parameters if performed during the pre-pubertal growth phase.
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Affiliation(s)
- Vincenzo Quinzi
- Department of Life, Health & Environmental Sciences, Postgraduate School of Orthodontics, University of L'Aquila, L'Aquila, Italy
| | - Simone Ettore Salvati
- Department of Life, Health & Environmental Sciences, Postgraduate School of Orthodontics, University of L'Aquila, L'Aquila, Italy
| | | | | | | | - Jasmina Primozic
- Department of orthodontics and jaw orthopaedics, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
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Patano A, Malcangi G, Inchingolo AD, Garofoli G, De Leonardis N, Azzollini D, Latini G, Mancini A, Carpentiere V, Laudadio C, Inchingolo F, D'Agostino S, Di Venere D, Tartaglia GM, Dolci M, Dipalma G, Inchingolo AM. Mandibular Crowding: Diagnosis and Management-A Scoping Review. J Pers Med 2023; 13:jpm13050774. [PMID: 37240944 DOI: 10.3390/jpm13050774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Crowding is the most frequent malocclusion in orthodontics, with a strong hereditary tendency. It already occurs in pediatric age and is mainly hereditary. It is a sign of a lack of space in the arches, and is not self-correcting, but can worsen over time. The main cause of the worsening of this malocclusion is a progressive and physiological decrease in the arch perimeter. METHODS To identify relevant studies investigating the most common possible treatments for mandibular dental crowding, a comprehensive search of PubMed, Scopus and Web of Science was conducted encompassing the last 5 years (2018-2023) using the following MeSH: "mandibular crowding AND treatment" and "mandibular crowding AND therapy ". RESULTS A total of 12 studies were finally included. An orthodontic treatment cannot ignore the concept of "guide arch", which concerns the lower arch, because of the objective difficulty in increasing its perimeter; the bone structure of the lower jaw is more compact than that of the upper one. Its expansion, in fact, is limited to a slight vestibularization of the incisors and lateral sectors that may be associated with a limited distalization of the molars. CONCLUSIONS There are various therapeutic solutions available to the orthodontist, and a correct diagnosis through clinical examination, radiographs and model analysis are essential. The decision of how to deal with crowding cannot be separated from an overall assessment of the malocclusion to be treated.
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Affiliation(s)
- Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | | | - Grazia Garofoli
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Nicole De Leonardis
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Daniela Azzollini
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Giulia Latini
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Vincenzo Carpentiere
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Claudia Laudadio
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Silvia D'Agostino
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, 66100 Chieti, Italy
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy
- UOC Maxillo-Facial Surgery and Dentistry, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Marco Dolci
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, 66100 Chieti, Italy
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
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Al Hummayani FM. Modified serial extraction treatment in a patient with congenitally missing lower second premolars. J Orthod Sci 2015; 4:92-6. [PMID: 26229951 PMCID: PMC4504050 DOI: 10.4103/2278-0203.160247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Serial extraction is a sequential plan of premature removal of one or more deciduous teeth in order to improve the alignment of permanent teeth and then removal of permanent teeth to maintain the proper ratio between tooth size and arch size. The aim of this case report was to present a case treated successfully with a modified serial extraction protocol in the lower arch because the patient had congenitally missing lower second premolars with severe crowding. The treatment consisted of selective removal of the deciduous mandibular teeth only (C, D, and E) and no permanent premolar removal. However, the space of the missing second premolars was utilized to resolve the anterior crowding along with the spontaneous closure of the extra spaces by physiologic movement of the permanent mandibular teeth. Whereas in the upper arch conventional serial extraction was performed.
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