Orthodontic extraction practices: a cross-sectional survey of orthodontists in Australia
e | 06 lug 2022
INFORMAZIONI SU QUESTO ARTICOLO
Pubblicato online: 06 lug 2022
Pagine: 227 - 236
Ricevuto: 01 gen 2022
Accettato: 01 feb 2022
DOI: https://doi.org/10.2478/aoj-2022-0013
© 2022 Maurice J. Meade et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Figure 1.
Figure 2.
Changes in approach to managing moderate crowding in Class I patients by orthodontists whose prescribed extraction rates had decreased over the past 5–10 years.
| Patient | Treatment approach | Change over the past 5–10 years |
||
|---|---|---|---|---|
| More | Less | No Change | ||
| Child/Adolescent | Extraction of all first PMs | 1 (2.4) | 27 (64.3) | 14 (33.3) |
| Extraction of all second PMs | 16 (37.2) | 15 (34.9) | 12 (27.9) | |
| Other extractions | 2 (4.7) | 9 (20.9) | 32 (74.4) | |
| IPR | 19 (44.2) | 0 | 24 (55.8) | |
| Transverse expansion | 19 (45.2) | 3 (7.1) | 20 (47.7) | |
| Incisor proclination | 18 (41.9) | 3 (7) | 22 (51.1) | |
| Distal movement with TADs | 12 (29.3) | 3 (7.3) | 26 (63.4) | |
| Combined IPR and arch lengthening | 24 (55.8) | 0 | 19 (44.2) | |
| Adult | Extraction of all first PMs | 0 | 24 (58.5) | 17 (41.5) |
| Extraction of all second PMs | 8 (20.5) | 15 (38.5) | 16 (41) | |
| Other extractions | 5 (13.5) | 9 (24.3) | 23 (62.2) | |
| IPR | 34 (85) | 0 | 6 (15) | |
| Transverse expansion | 16 (41) | 3 (7.7) | 20 (51.3) | |
| Incisor proclination | 20 (50) | 2 | 18 | |
| Distal movement with TADs | 7 (18.4) | 4 (10.5) | 27 (71.1) | |
| Combined IPR and arch lengthening | 23 (57.5) | 1 (2.5 | 16 (40) | |
Level of influence of various factors on extraction decisions by orthodontists whose prescribed extraction rates had decreased over the past 5 to10 years.
| Patient group | Factor | Influence |
|||
|---|---|---|---|---|---|
| Major | Moderate | Minor | None | ||
| Child/Adolescent | Facial aesthetics | 24 (54.54) | 17 (38.63) | 1 (2.27) | 2 (4.58) |
| Smile aesthetics | 18 (40.91) | 18 (40.91) | 5 (11.36) | 3 (6.82) | |
| TMJ symptoms | 2 (4.58) | 3 (6.82) | 10 (22.73) | 29 (65.87) | |
| Appliances used | 5 (11.36) | 8 (18.18) | 18 (40.91) | 13 (29.55) | |
| Increased use of IPR | 6 (13.64) | 19 (43.18) | 15 (34.1) | 4 (9.08) | |
| Increased use of transverse expansion | 2 (4.58) | 17 (38.64) | 20 (45.55) | 5 (11.23) | |
| Periodontal implications | 14 (32.56) | 13 (30.23) | 12 (27.91) | 4 (9.3) | |
| Stability due to effect of extractions | 2 (4.58) | 12 (27.28) | 17 (38.59 | 13 (29.55) | |
| Treatment duration | 0 | 11 (25) | 23 (52.3) | 10 (22.7) | |
| Change in mode of anchorage supplementation | 2 (4.58) | 11 (25) | 18 (40.91) | 13 (29.51) | |
| Change in rate of BR use | 6 (13.64) | 7 (15.93) | 10 (22.7) | 21 (47.73) | |
| Adult | Facial aesthetics | 20 (47.62) | 17 (40.48) | 2 (4.76) | 3 (7.14) |
| Smile aesthetics | 20 (47.62) | 14 (33.33) | 4 (9.53) | 4 (9.53) | |
| TMJ symptoms | 0 | 3 (7.14) | 10 (23.81) | 29 (69.05) | |
| Appliances used | 6 (14.29) | 6 (14.29) | 18 (42.86) | 12 (28.56) | |
| Increased use of IPR | 6 (14.29) | 18 (42.86) | 16 (38.1) | 2 (4.76) | |
| Increased use of transverse expansion | 2 (4.76) | 17 (40.48) | 19 (45.24) | 4 (9.52) | |
| Periodontal implications | 14 (34.15) | 12 (29.27) | 11 (26.83) | 4 (9.76) | |
| Stability due to effect of extractions | 4 (9.52) | 8 (19.05) | 17 (40.48) | 13 (30.95) | |
| Treatment duration | 1 (2.4) | 10 (23.81) | 25 (50.95) | 6 (14.29) | |
| Change in mode of anchorage supplementation | 2 (4.76) | 11 (26.2) | 20 (47.62) | 9 (21.42) | |
| Change in rate of BR use | 6 (14.29) | 7 (16.67) | 8 (19.04) | 21 (50) | |
Level of influence of various factors on extraction decisions by orthodontists whose prescribed extraction rates had increased over the past 5 to10 years.
| Patient group | Factor | Influence | |||
|---|---|---|---|---|---|
| Major | Moderate | Minor | None | ||
| Child/Adolescent | Facial aesthetics | 2 (18.19) | 5 (45.43) | 2 (18.19) | 2 (18.19) |
| Smile aesthetics | 2 (18.19) | 5 (45.43) | 2 (18.19) | 2 (18.19) | |
| TMJ symptoms | 0 | 0 | 3 (27.27) | 8 (72.27) | |
| Appliances used | 0 | 1 (9.09) | 1 (9.09) | 9 (81.81) | |
| Increased use of IPR | 0 | 0 | 9 (81.81) | 2 (18.19) | |
| Increased use of transverse expansion | 0 | 0 | 3 (27.27) | 8 (72.73) | |
| Periodontal implications | 2 (18.19) | 3 (27.27) | 2 (18.19) | 4 (36.35) | |
| Stability due to effect of extractions | 9 (81.81) | 2 (18.19) | 0 | 0 | |
| Treatment duration | 0 | 3 (27.27) | 6 (54.54) | 2 (18.19) | |
| Change in mode of anchorage supplementation | 0 | 0 | 2 (18.19) | 9 (81.81) | |
| Change in rate of BR use | 0 | 2 (18.19) | 6 (54.54) | 3 (27.27) | |
| Adult | Facial aesthetics | 1 (14.29) | 0 | 2 (28.58) | 4 (57.16) |
| Smile aesthetics | 1 (14.29) | 0 | 2 (28.58) | 4 (57.16) | |
| TMJ symptoms | 0 | 0 | 1 (14.29) | 6 (85.74) | |
| Appliances used | 0 | 1 (14.29) | 1 (14.29) | 5 (71.45) | |
| Increased use of IPR | 0 | 0 | 3 (42.87) | 4 (57.16) | |
| Increased use of transverse expansion | 0 | 0 | 0 | 7 (100) | |
| Periodontal implications | 0 | 0 | 1 (14.29) | 6 (85.74) | |
| Stability due to effect of extractions | 1 (14.29) | 4 (57.16) | 0 | 2 (28.58) | |
| Treatment duration | 0 | 2 (28.58) | 3 (42.87) | 2 (28.58) | |
| Change in mode of anchorage supplementation | 0 | 0 | 0 | 7 (100) | |
| Change in rate of BR use | 0 | 0 | 3 (42.87) | 4 (57.16) | |
Summary of participant demographic details.
|
|
|
|---|---|
| Gender | |
| Male | 116 (71.2) |
| Female | 43 (26.4) |
| Prefer not to say | 4 (2.4) |
| Where specialist qualification acquired | |
| Australia | 139 (85.28) |
| New Zealand | 3 (1.84) |
| Other | 21 (12.88) |
| Work type | |
| Private | 136 (83.4) |
| Public/university and private | 22 (13.5) |
| Public/university | 2 (1.2) |
| Other | 3 (1.9) |
| State/Territory of main workplace | |
| NSW / ACT | 49 (30) |
| Queensland | 31 (19) |
| South Australia / NT | 25 (15.33) |
| Victoria/Tasmania | 38 (23.31) |
| Western Australia | 20 (12.36) |
Changes in approach to managing moderate crowding in Class I patients by orthodontists whose prescribed extraction rates had increased over the past 5–10 years.
| Patient | Treatment approach | Change over the past 5–10 years N (%) | ||
|---|---|---|---|---|
| More | Less | No change | ||
| Child/Adolescent | Extraction of all first PMs | 9 (75) | 2 (16.7) | 1 (8.3) |
| Extraction of all second PMSs | 8 (66.6) | 2 (16.7) | 2 (16.7) | |
| Other extractions | 7 (58.3) | 2 (16.7) | 3 (25) | |
| IPR | 3 (25) | 5 (41.7) | 4 (33.3) | |
| Transverse expansion | 0 | 4 (33.3) | 8 (66.7) | |
| Incisor proclination | 5 (41.7) | 3 (25) | 4 (33.3) | |
| Distal movement with TADs | 0 | 6 (50) | 6 (50) | |
| Combined IPR and arch lengthening | 0 | 6 (50) | 6 (50) | |
| Adult | Extraction of all first PMs | 3 (30) | 3 (30) | 4 (40) |
| Extraction of all second PMs | 6 (60) | 1 (10) | 3 (30) | |
| Other extractions | 3 (30) | 2 | 5 (50) | |
| IPR | 4 (44.4) | 2 (22.2) | 3 (33.3) | |
| Transverse expansion | 0 | 1 (10) | 9 (90) | |
| Incisor proclination | 2 | 2 | 6 (60) | |
| Distal movement with TADs | 0 | 5 (50) | 5 (50) | |
| Combined IPR and arch lengthening | 0 | 5 (50) | 5 (50) | |