Evaluation of the airway space changes after extraction of four second premolars and orthodontic space closure in adult female patients with bimaxillary protrusion - A retrospective study

Background & objectives: Previous studies have found that first premolar extractions during orthodontic treatment may alter the upper airway dimensions. The objective of this study is to investigate the effects of second premolar extraction during orthodontic treatment on the dimensions of the upper airway in a sample of female adults. Methods: Twenty-nine female adult patients with ages between 18 and 30 years old and incisor bimaxillary protrusion were included in this study. They were treated with comprehensive orthodontic treatment which included the extraction of four second premolars. Pre and post cephalometric radiographs were analyzed using Dolphin imaging software for changes in tongue length and height, soft palate thickness and length, the superior, middle, and inferior airway space, and vertical airway length. Descriptive statistics were used to characterize measurements. Student's paired t-test was preformed to compare the pre- and post-test mean values of the dimensions. Results: A significant increase in the vertical airway length was observed after the extraction of the second premolars (p = 0.02). The soft palate length showed a tendency towards an increase that did not reach statistical significance (p = 0.053). No other significant changes in the airway soft tissue measurements were observed. The proclination and protrusion of the upper and lower incisors were significantly decreased compared to pre-treatment measurements. Interpretation & conclusions. Orthodontic treatment involving the extraction of all four second premolars in females with bimaxillary protrusion increases the vertical airway length, which is the amount of distance between base of the tongue and posterior nasal spine. No other significant alterations in the upper airway measurements were observed. (C) 2019 The Authors. Production and hosting by Elsevier B.V. on behalf of King Saud University.