Extraction of premolars for orthodontic reasons on the decline? A cross-sectional survey of BOS members
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Accepted Version
Date
2018-09-07
Authors
Fleming, Padhraig S.
Cunningham, Susan J.
Benson, Philip E.
Jauhar, Preeti
Millett, Declan
Journal Title
Journal ISSN
Volume Title
Publisher
Taylor and Francis
Published Version
Abstract
Objective: To obtain the opinion of British Orthodontic Society (BOS) members in relation to possible patterns of prescription of orthodontic extractions over the past 5–10 years and to relate any changes identified to treatment objectives, facial and smile aesthetics, and treatment strategies and adjuncts. Design: Cross-sectional questionnaire. Setting: On-line survey of BOS members. Methods: A 14-item on-line questionnaire was sent to orthodontic practitioners for completion. The questionnaire covered demographics, possible changes in frequency of prescribed extractions with specific information concerning the effect of patient age, and the influence of other factors including alternative approaches to space creation, evolving treatment mechanics, smile and facial aesthetics, and retention protocols. Results: Two hundred and eight responses were obtained with 95.6% (n = 199) reporting reduced extraction prescription over the last 5–10 years. Overall, 29.9% and 35.5% felt that their threshold for extractions had increased by more than 2 mm in adolescents and adults, respectively. Facial (n = 145; 69.7%) and smile (n = 127; 61.1%) aesthetics, and increased use of inter-proximal reduction (n = 102; 49%) were the factors most frequently reported as having either a moderate or major influence on this trend. Based on ordinal logistical regression analyses, no significant relationship was found between threshold for extractions and work setting (P = 0.675; O.R. 0.51; 95% CI: 0.39, 1.85) or level of orthodontic experience (P = 0.15; O.R. 1.02; 95% CI: 0.15, 1.05), although a higher threshold for extractions was more likely among users of conventional than self-ligating brackets (P = 0.001; O.R. 4.74; 95% CI: 1.95, 11.5). Conclusions: A reduced tendency to prescribe orthodontic extractions over the past 5–10 years among British Orthodontic Society members was identified. Comparative clinical research exploring the relative merits of extraction and non-extraction approaches could be timely.
Description
Keywords
Extraction , Non-extraction , Orthodontic
Citation
Fleming, P. S., Cunningham, S. J., Benson, P. E., Jauhar, P. and Millett, D. (2018) 'Extraction of premolars for orthodontic reasons on the decline? A cross-sectional survey of BOS members', Journal of Orthodontics, 45(4), pp. 283–288. https://doi.org/10.1080/14653125.2018.1517470
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Copyright
© 2018, British Orthodontic Society. Published by Taylor & Francis. All rights reserved. This is an Accepted Manuscript of an article published by Taylor & Francis in Journal of Orthodontics on 7 September 2018, available online: https://doi.org/10.1080/14653125.2018.1517470