Abstract
Objective: To compare soft tissue changes in Class I borderline cases treated with extraction and nonextraction modalities. Methods: A parent sample of 150 patients with Class I dental and skeletal malocclusion (89 patients treated with premolar extraction and 61 patients without extraction) was randomly selected and subjected to discriminant analysis which identified the borderline sample of 44 patients (22 extraction and 22 nonextraction patients). Pretreatment and post-treatment cephalograms of the borderline subsample were analyzed using 22 soft tissue parameters. Results: Upper and lower lips were more retracted and thickness of the upper lip increased more in the borderline extraction cases (p < 0.01). The nasolabial angle became more obtuse and the interlabial gap was reduced in the borderline extraction cases (p < 0.01). Lower lip, interlabial gap and nasolabial angle showed no changes in the borderline nonextraction cases. Conclusion: The soft tissue parameters which can be used as guideline in decision making to choose either extraction or nonextraction in Class I borderline cases are upper and lower lip protrusion in relation to the E-plane and Sn-Pg' line, lower lip protrusion in relation to the true vertical line (TVL), upper lip thickness, nasolabial angle and interlabial gap.
Highlights
Orthodontics is the branch of Dentistry which mainly deals with malocclusion and dentofacial deformities and their correction for optimal function and esthetics
The aim of this study was to compare soft tissue changes in Class I borderline cases treated with extraction and nonextraction modalities and to identify those parameters which can act as guidelines to differentiate between these two treatment modalities in Class I borderline cases
From the results obtained in this study, it can be concluded that upper and lower lips were retracted more significantly, while upper lip thickness increased more significantly in the borderline extraction cases
Summary
Orthodontics is the branch of Dentistry which mainly deals with malocclusion and dentofacial deformities and their correction for optimal function and esthetics. In treating a Class I malocclusion, there are two main approaches in comprehensive Orthodontics: extraction and nonextraction. Extractions are routinely used to correct dental crowding and protrusion of teeth and the overlying soft tissue. The nonextraction approach requires expansion of the arches, molar distalization or proximal stripping. The common demerits of extraction treatment were hypothesized to be “dished-in profiles,” narrower dental arches, increased width of the buccal corridor; while those of nonextraction treatment were hypothesized to be poor stability and protrusive profile in borderline cases.[5]
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