Boley J C, Pontier J P, Smith S, Fulbright M
Angle Orthod. 1998 Dec;68(6):539-46. doi: 10.1043/0003-3219(1998)068<0539:FCIEAN>2.3.CO;2.
The purpose of this study was to determine if there are any differences in the posttreatment faces of patients treated nonextraction and those treated with premolar extraction in properly diagnosed and treated cases. The study was conducted in two parts. In Part 1, perceptions of 192 experienced general dentists and orthodontists were tested. Facial photos of 25 consecutively treated nonextraction patients and 25 consecutively treated four-premolar-extraction patients were shown to the study participants. They were asked if the patient was treated with the extraction of four premolars or without extractions. The mean score of the respondents was 54%, only slightly better than pure chance. In Part 2, profiles were evaluated based on cephalometric tracings. There was no significant difference between pretreatment and posttreatment profiles of the groups. The mean H-line values for both groups were within the desired esthetic range. It was concluded that experienced orthodontists and general dentists could not determine whether treatment was nonextraction or extraction by looking at the face alone. Also, there was no significant difference between the faces produced by the two types of treatments. Therefore, the avoidance of extracting premolars based on a fear of a significant detrimental effect on the face is unjustified when the case has been properly diagnosed and treated.
本研究的目的是确定在正确诊断和治疗的病例中，不拔牙治疗的患者与拔除前磨牙治疗的患者治疗后的面部情况是否存在差异。该研究分两部分进行。在第一部分中，对192名经验丰富的普通牙医和正畸医生的认知进行了测试。向研究参与者展示了25名连续接受不拔牙治疗的患者和25名连续接受拔除四颗前磨牙治疗的患者的面部照片。他们被问及患者是接受了四颗前磨牙拔除治疗还是未接受拔牙治疗。受访者的平均得分是54%，仅略高于随机猜测的水平。在第二部分中，根据头影测量描图对侧貌进行评估。两组治疗前和治疗后的侧貌没有显著差异。两组的平均H线值均在理想的美学范围内。研究得出结论，经验丰富的正畸医生和普通牙医仅通过观察面部无法确定治疗是不拔牙还是拔牙。此外，两种治疗方式所产生的面部情况之间没有显著差异。因此，当病例得到正确诊断和治疗时，基于担心对面部产生重大不利影响而避免拔除前磨牙是不合理的。
