Effects of bilateral upper first premolar extraction on the mandible

The purpose of this study was to evaluate the effects of bilateral upper premolar extraction on mandibular growth. Twenty-six subjects (eight males, 18 females) in maximum pubertal growth with an Angle Class II molar relationship, normal to mild overjet increase, mild or no lower arch length discrepancy but severe upper arch discrepancy and no severe skeletal discrepancy were divided into two groups equal in number and gender, as extraction and control groups. The median chronological age was 11.2 years in the extraction group and 12.6 years in the controls. The subjects were observed for a median period of 1.1 years in the extraction group after bilateral extraction of the upper premolars and 1.2 years in the controls until termination of pubertal growth (DP3u) without any orthodontic treatment. Twenty-nine linear and angular measurements were made on 52 lateral cephalograms and hand-wrist radiographs taken before and after the study period. The increase in SNB measured on the total superimposition was significantly greater in the controls than in the extraction group (P < 0.05). In addition, anterior mandibular (counter-clockwise) rotation was only significant (P < 0.05) in the control group. Thus, it might be suggested that bilateral upper premolar extractions might affect the mandibular rotation tendency.