Reinventing serial extraction with a fresh perspective: does it inspire a change in current practice?

Abstract

To analyze the skeletal and dental effects of serial extraction with and without expansion on severe crowding. A retrospective controlled study using lateral cephalograms of 78 children of age 8.5 + /- 1.4 years. The study sample involved 52 orthodontic patients treated for severe crowding and 26 age matched controls who did not undergo orthodontic treatment. The treated cases were sorted into serial extraction (EX) only group and serial extraction and expansion (EX-EXP) group. Vertical and anteroposterior skeletal and dental cephalometric measurements of these subjects were analyzed at baseline time point and following eruption of posterior permanent dentition. The study found significant changes in vertical skeletal dimensions with a decrease in mandibular and occlusal plane angles in the experimental groups at the follow up. The facial height index was noted to be increased. The upper gonial angle decreased significantly in the groups that had extractions. There was no significant change in the inter-incisal angle among the groups, yet at follow-up the inter-incisal angle of the control group was significantly smaller than the intervention groups. The article concludes that serial extraction alone or in combination with expansion treatment performed prior to pubertal growth phase have comparable skeletal cephalometric findings primarily affecting the vertical dimension.