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Extractions as a form of interception in the developing dentition: a randomized controlled trial

University of Wales College of Medicine, UK

F. A. Miotti

University of Padova, Italy

W. Harzer

Technische Universitat Dresden, Germany

Address for correspondence: Dr Chung How, Kau, Department of Dental Health and Biological Sciences, University of Wales, College of Medicine Heath Park, Cardiff CF14 4XY, Wales, UK. Email: Kauc{at}cardiff.ac.uk

Objective: To determine if the extractions of lower primary canines are an effective procedure to relieve crowding of the labial segment.

Study design: randomized controlled trial.

Subject sample: 83 cases were collected in clinics in Italy, Germany and Wales. The groups were followed over a 2-year period.

Method: Subjects were randomly allocated to a primary canine non-extraction or extraction group. Dental casts of the patients were collected at the start and at the recall period of the trial. The outcome measures recorded were lower incisor crowding, arch length, intermolar width, overbite, overjet, lower clinical crown heights and lower incisor inclinations.

Statistics: The Mann–Whitney test was used to compare the differences between the extraction and non-extraction groups.

Results: In both groups, crowding reduced 1.27 mm in the non-extraction group and 6.03 mm in the extraction group. The difference between the 2 groups was 4.76 mm (P<0.05). The arch perimeter decreased more in the extraction group by 2.73 mm (P<0.05). As the incisor inclination stayed essentially the same, the loss in arch length was attributed to the molars moving forward. The net gain from extracting deciduous canines was 2.03 mm.

Conclusions: There was a reduction in lower incisor crowding as a result of lower primary canine extraction. However, arch perimeter decreased more in the extraction group leaving less space for the eruption of the lower secondary canines.

Key words: Interceptive orthodontics, extraction of primary canines, incisor crowding, randomized controlled trial

This paper is based upon the Chapman Prize winning essay of the British Orthodontic Society, awarded in 2002.