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Influence of premolar extractions on long-term adult facial aesthetics and apparent age.

OBJECTIVES
This study aimed to assess whether non-extraction, two-premolars and four-premolars extraction Class II treatment protocols are different regarding long-term facial aesthetics, age appearance, and soft-tissue measures.


METHODS
Frontal and lateral photographs of 63 full Class II division 1 patients, treated at least 8 years before, were evaluated by 83 laypeople and 76 orthodontists, who assigned to each one's attractiveness scores from 1 to 10, and opined about their apparent ages. Patients were divided in three groups: XP0 (non-extraction, n = 20; 30.77 years, 15.63 years post-treatment), XP2 (two-premolars extractions, n = 25; 30.99 years, 15.68 years post-treatment), and XP4 (four-premolar extractions, n = 18; 32.80 years, 18.01 years post-treatment), that were matched by gender, post-treatment occlusal and soft-tissue outcomes, age, and post-treatment time. Soft-tissue measures were obtained with Dolphin Imaging 11.5 software.


RESULTS
Two-way analysis of variance revealed that attractiveness and apparent age were not affected by treatment protocols, but laypeople were slightly more critical then orthodontists. Analysis of variance showed more vertical facial pattern in XP4 group. Pearson correlation test revealed no influence of soft-tissue measures on sample's attractiveness.


CONCLUSIONS
Treatment of full Class II division 1 malocclusion with and without extractions did not influence facial attractiveness, age appearance, and overall soft-tissue measures in the long-term.