Premolar Çekiminin Sert ve Yumuşak Doku Profili Değişiklikleri Üzerindeki Etkisinin Değerlendirilmesi

Yıl 2025, Cilt: 16 Sayı: 3, 413 - 421, 22.12.2025

Elif Albayrak , Aybüke Dilara Arslan , Neslihan Şenışık

https://doi.org/10.22312/sdusbed.1702714

Öz

Amaç: Maksiller iki veya dört premolar diş çekimi yapılmış 16 yaş üzeri hastalarda tedavi öncesi ve sonrası sefalometrik filmlerde sert ve yumuşak doku profil değişikliklerini değerlendirmektir. Gereç ve Yöntem: Ortodontik tedavisi tamamlanmış toplam 68 hastanın sefalometrik radyografileri analiz edilmiştir. Ölçümler dört birinci premolar dişi çekilmiş 40 hasta ile üst iki premolar dişi çekilmiş 28 hastanın kayıtları üzerinden yapılmıştır. Tedavi öncesi (T1) ve tedavi sonrası (T2) değerleri karşılaştırılmıştır. Verilerin normal dağılımını değerlendirmek için Shapiro-Wilk testi, tedavi öncesi ve sonrası karşılaştırmalar için paired samples t-test ve independent samples t-test kullanılmıştır. Anlamlılık düzeyi p<0,05 alınmıştır. Bulgular: Dört premolar çekimli grupta, üst ve alt keser dişlerin E-düzlemine olan uzaklıkları ve dudak kalınlığı ile dudak uzunluğu sayısal olarak artmış ancak istatistiksel olarak anlamlı bulunmamıştır (p>0,05). İki premolar çekimli grupta alt dudak kalınlığı artmıştır (p<0,05). Parametrelerin gruplar arası bağımsız karşılaştırılmasında nazolabial açıda iki grup arasında T1 de fark yokken T2 de istatistiksel olarak artmıştır. SNA açısı, dört premolar çekimli grupta sayısal olarak azalırken iki premolar çekimli grupta artmıştır. Her iki grupta da nazolabial açı anlamlı düzeyde artmıştır. Sonuç: Her iki çekim grubunda da kesici diş retraksiyonu sonucunda ortaya çıkan dudak retraksiyonu ile minimal düzeyde profil değişikliği elde edilmiştir. Çekimli tedavi, dudakların geriye hareketinin istendiği vakalarda değerlendirilebilir.

Anahtar Kelimeler

Estetik , Premolar çekimi , Profil değişimi

Evaluation of the Effect of Premolar Extraction on Hard and Soft Tissue Profile Changes

Öz

Objectıve: To evaluate the hard and soft tissue profile changes in pre- and post-treatment cephalometric films in patients over 16 years of age who underwent maxillary two or four premolar tooth extraction. Materials and Methods: Cephalometric radiographs of 68 patients who completed orthodontic treatment were analyzed. Measurements were made on the records of 40 patients who had four first premolars extracted and 28 patients who had two upper premolars extracted. Pre-treatment (T1) and post-treatment (T2) values were compared. The Shapiro-Wilk test was used to evaluate the normal distribution of the data, and paired t-test and independent t-test were used for pre-treatment and post-treatment comparisons. The significance level was taken as p<0.05. Results: In the four premolar extraction group, the distances of the upper and lower incisors to the E-plane and lip thickness and lip length increased numerically but were not found to be statistically significant (p>0.05). The lower lip thickness increased in the two premolar extraction group (p<0.05). In the independent comparison of the parameters between the groups, there was no difference in the nasolabial angle between the two groups at T1, but it increased statistically at T2. The SNA angle decreased numerically in the four premolar extraction group, but increased in the two premolar extraction group. The nasolabial angle increased significantly in both groups. Conclusion: In both extraction groups, minimal profile change was achieved with lip retraction resulting from incisor retraction. Extraction treatment can be considered in cases where the lips are desired to move backward.

Anahtar Kelimeler

Aesthetics , Premolar extraction , Profile change

Kaynakça

• 1. Lim YN, Yang BE, Byun SH, Yi SM, On SW, Park IY. Three-Dimensional Digital Image Analysis of Skeletal and Soft Tissue Points A and B after Orthodontic Treatment with Premolar Extraction in Bimaxillary Protrusive Patients. Biology (Basel). 2022;11(3):381. Published 2022 Feb 27.
• 2. Erdinc AE, Nanda RS, Dandajena TC. Profile changes of patients treated with and without premolar extractions. Am J Orthod Dentofacial Orthop. 2007;132(3):324-331. doi:10.1016/j.ajodo.2005.08.045
• 3. Ricketts RM. Cephalometric synthesis. Am J Orthod 1960;46: 647-73.
• 4. Dardengo Cde S, Fernandes LQ, Capelli Júnior J. Frequency of orthodontic extraction. Dental Press J Orthod. 2016;21(1):54-59.
• 5. Basciftci FA, Usumez S. Effect sofextraction and nonextraction treatment on Class I and Class II subjects. Angle Orthod. 2003;73:36-42.
• 6. Mirabella D, Quartarone L, Lombardo L, Guarneri A, Guarneri MP, Siciliani G. Assessment of lower lip changes following incisor displacement in 92 orthodontically-treated adults. Int Orthod 2012;10:289-310.
• 7. Kang H. Sample size determination and power analysis using the G*Power software. J Educ Eval Health Prof. 2021;18:17.
• 8. Lim HJ, Ko KT, Hwang HS. Esthetic impact of premolar extraction and nonextraction treatments on Korean borderline patients. Am J Orthod Dentofacial Orthop 2008;133: 524-531.
• 9. Chen YJ, Chen SK, Yao JC, Chang HF. Effect of differences in landmark identification on the cephalometric measurements in traditional versus digitized cephalometry. Angle Orthod 2004;74,155-61.
• 10. Travess H, Roberts-Harry D, Sandy J. Orthodontics. Part 8: Extractions in orthodontics. Br Dent J. 2004;196(4):195-203.
• 11. Creekmore TD. Where teeth should be positioned in the face and jaws and how to get them there. J Clin Orthod. 1997;31(9):586-608.
• 12. Dewel, BF. Second Premolar Extraction in Orthodontics: Principles, Procedures and Case Analysis. Am J Orthod. 41:107-20, 1955.
• 13. Turner RA. Quantitative Analysis of First Versus Second Premolar Extraction Effects in Orthodontic Treatment. The Graduate Studies Council The University of Tennessee Health Science Center, 2007.
• 14. Bos A, Vosselman N, Hoogstraten J, Prahl-Andersen B. Patient compliance: a determinant of patient satisfaction?. Angle Orthod. 2005;75(4):526-531.
• 15. Omar Z, Short L, Banting DW, Saltaji H. Profile changes following extraction orthodontic treatment: A comparison of first versus second premolar extraction. Int Orthod. 2018;16(1):91-104.
• 16. Bravo LA. Soft tissue facial profile changes after orthodontic treatment with four premolars extracted. The Angle Orthod 1994;64:3-42.
• 17. Erdinc AE, Nanda RS, Dandajena TC. Profile changes of patients treated with and without premolar extractions. Am J Orthod Dentofacial Orthop 2007;132:324-331.
• 18. Sadry S, Koru BE, Kayalar E. Analyzing the effects of tooth extraction on the lip in orthodontic treatment. J Stomatol Oral Maxillofac Surg. 2022;123(4):e126-e132. doi:10.1016/j.jormas.2022.04.004
• 19. Albertini P, Barbara L, Albertini E, Willeit P, Lombardo L. Soft-tissue profile changes in adult patients treated with premolar extractions. Am J Orthod Dentofacial Orthop. 2024;166(2):171-178.
• 20. Oliver BM. The influence of lip thickness and strain on upper lip response to incisor retraction. Am J Orthod. 1982;82:141-149.
• 21. KILINÇ, Delal. Investigation of the effects of treatment with and without premolar extraction on facial soft tissues. 7tepe Clinic. 2018;14.3.
• 22. ÇOBAN, Gökhan; TOZAR, Ayşe; ÖZTÜRK, Taner. The Effect of Four I. Premolar and Upper Two I. Premolar Extractions on Hard and Soft Tissues in Skeletal Class II Camouflage Treatment. 2024;45.2:77-84
• 23. Yashwant VA, KR, Arumugam E. Comparative evaluation of soft tissue changes in Class I borderline patients treated with extraction and nonextraction modalities. Dental Press J Orthod 2016;21:50-59.
• 24. Ioi H, Nakata S, Nakasima A, Counts AL. Anteroposterior lip positions of the most-favored Japanese facial profiles. Am J Orthod Dentofacial Orthop. 2005;128(2):206-211.
• 25. Ramos AL, Sakima MT, Pinto Ados S, Bowman SJ. Upper lip changes correlated to maxillary incisor retraction--a metallic implant study. Angle Orthod. 2005;75(4):499-505.