Effect of Premolar Extraction on the Upper Airway in Adult and Adolescent Orthodontic Patients: a Meta-analysis.

Objective: To analyse the effects of premolar extraction on the upper airway in adult and adolescent orthodontic patients using CBCT.

Methods: The Embase, Web of Science, Cochrane Library and Medline (via PubMed) databases were searched with no language restrictions. Longitudinal studies in which CBCT was applied to assess the effects of tooth extraction on the upper airway were included in the analysis. Two authors performed the study selection, methodological quality assessment, data extraction and data synthesis independently.

Results: A total of 12 studies were included, six of which were eligible for quantitative synthesis. In the adult group, the nasopharynx and oropharynx volume showed no significant change, and the minimum cross-sectional area of the upper airway demonstrated a non-significant decrease compared to the non-extraction group. In the adolescent group, the nasopharynx volume, oropharynx volume and minimum cross-sectional area of the upper airway increased in a non-significant manner.

Conclusion: The currently available evidence indicates that tooth extraction does not increase the risk of airway collapse in adult and adolescent patients. The present findings should be interpreted with caution and evaluated in further high-quality studies.