Mesial movement of maxillary first molars and vertical dimensional changes in orthodontic extraction treatment for patients with different facial morphology

Abstract

Objectives: Primarily, to compare anchorage loss and changes in mandibular plane (MP) angle, overbite, and amount of horizontal, vertical, and angular movements of maxillary incisors in groups of hypodivergent, hyperdivergent, and normodivergent patients. Secondarily, to analyze the relationship between those factors. Methods: Pre- and post-treatment cephalograms of 89 patients treated with extraction of four bicuspids or two maxillary bicuspids were analyzed. The sample was divided into three groups based on their facial pattern measured by SN-MP angle (hypodivergent: < 270, hyperdivergent: >380, and normodivergent: 270-380). Linear and angular measurements included the distances of U1 tip and U6 mesial height of contour to Y-axis (i.e., line perpendicular to the X-axis, passing through Sella turcica), distance of U1 tip to Sella on X-axis, overbite, angulation of U1 to palatal plane, and SN-MP and ANB angles. Inferential statistics included one-way ANOVA, Chi-square test, independent t-test, and Pearson’s correlation coefficients. Results: Facial morphology did not primarily affect anchorage loss, because other factors such as crowding, severity of Class II molar relationship, and extraction modality played more impactful role (P< 0.01). Change in mandibular plane angle was neither influenced by, nor correlated with, initial facial morphology or anchorage loss (P> 0.05). Positive change in overbite was significantly correlated with facial pattern, incisor extrusion and retroclination (r= 0.30, 0.44, and -0.35, respectively, P< 0.01). Conclusion: Anchorage loss in extraction orthodontic treatment is not influenced primarily by initial facial morphology. Anchorage loss is not significantly associated with MP angle reduction. Change in overbite can be achieved through incisor extrusion and retroclination.