Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/1807-2577.20250019
Revista de Odontologia da UNESP
Original Article

Three-dimensional analysis of dental arch changes after first premolar extractions and en masse or two-step retraction in Class I biprotrusions

Análise tridimensional das alterações da arcada dentária após extração de primeiros pré-molares e retração em massa ou em dois tempos em Classes I biprotrusões

Alyssa Schiavon GANDINI; Taynara de Oliveira FURTADO; Carolina Carmo de MENEZES; Luiz Gonzaga GANDINI JUNIOR; Henrique Barcelos BRANDÃO; Ary dos SANTOS- PINTO

http://dx.doi.org/10.1590/1807-2577.20250019 Rev. odontol. UNESP, vol.54, e20250019, 2025
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Abstract

Introduction: The extraction of permanent teeth, particularly premolars, has been a subject of debate in orthodontics centered on the space requirements for resolving malocclusion and its potential impact on the development of dental arches.

Objective: This study evaluated dimensional changes in the upper and lower dental arches following first premolar extractions and space closure using en masse retraction (EMR) and two-step retraction (TSR) in Class I biprotrusion cases.

Material and method: Study models of 46 Brazilian adults pre- and post-premolar extraction and space closure by ERM or TSR, were scanned in a 3D scanner and analyzed using the 3Shape OrthoAnalyzer™. The parameters evaluated included overjet, overbite, intercanine and intermolar distances (cusp and cervical level), arch length and arch perimeter.

Result: No significant differences were observed between EMR and TSR. Both techniques resulted in significant reductions in overjet (0.7 mm) and arch dimensions, including decreased intermolar distances (cusp: 1.57 mm; cervical: upper 1.74 mm, lower 1.25 mm) and reduced arch length (upper: 7.25 mm; lower: 6.40 mm) and perimeter (upper: 16.17 mm; lower: 14.5 mm). Conversely, cervical intercanine distances increased (upper: 1.73 mm; lower: 2.21 mm).

Conclusion: EMR and TSR produced comparable outcomes in arch dimensional changes. Premolar extraction with space closure maintains the overbite, reduced overjet and intermolar widths while expanding cervical intercanine distances. Both techniques led to significant decreases in arch length and perimeter.

Keywords

Corrective orthodontics; three-dimensional imaging; dental models; dental arch; tooth extraction

Resumo

Introdução: A extração de dentes permanentes, particularmente pré-molares, tem sido objeto de debate na ortodontia centrado nos requisitos de espaço para a resolução da má oclusão e seu potencial impacto no desenvolvimento das arcadas dentárias.

Objetivo: Este estudo avaliou as alterações dimensionais nas arcadas dentárias superior e inferior após extrações de primeiros pré-molares e fechamento de espaço utilizando retração em massa (EMR) e retração em duas etapas (TSR) em casos de Classe I biprotrusão.

Material e método: Modelos de estudo de 46 adultos brasileiros pré e pós extração de pré-molares e fechamento de espaço por ERM ou TSR, foram digitalizados em scanner 3D e analisados usando o 3Shape OrthoAnalyzer™. Os parâmetros avaliados incluíram overjet, overbite, distâncias intercaninos e intermolar (nível de cúspide e cervical), comprimento e perímetro de arco.

Resultado: Não foram observadas diferenças significativas entre EMR e TSR. Ambas as técnicas resultaram em reduções significativas no overjet (0,7 mm) e nas dimensões da arcada, incluindo diminuição nas distâncias intermolar (cúspide: 1,57 mm; cervical: superior 1,74 mm, inferior 1,25 mm) e redução no comprimento de arco (superior: 7,25 mm; inferior: 6,40 mm) e perímetro de arco (superior: 16,17 mm; inferior: 14,5 mm) da arcada. Por outro lado, as distâncias cervicais intercaninos aumentaram (superior: 1,73 mm; inferior: 2,21 mm).

Conclusão: EMR e TSR produziram resultados comparáveis nas alterações dimensionais dos arcos dentários. A extração de pré-molares com fechamento de espaço manteve o overbite, reduziu o overjet e as larguras intermolar, enquanto aumentou as distâncias cervicais intercaninos. Ambas as técnicas levaram a reduções significativas no comprimento e perímetro de arco.

Palavras-chave

Ortodontia corretiva; imagem tridimensional; modelos dentários; arco dentário; extração dentária

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Submitted date:
07/12/2025

Accepted date:
10/16/2025

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