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Orthodontic extraction practices: a cross-sectional survey of orthodontists in Australia Cover

Orthodontic extraction practices: a cross-sectional survey of orthodontists in Australia

Open Access
|Jul 2022

Figures & Tables

Figure 1.

Distribution of primary fixed appliance by training and by current usage (by % number of orthodontists). Notes: PEC: Pre-adjusted Edgewise (Conventional Ligation); PESL: Pre-adjusted Edgewise (Self-ligation); T-E: Tip Edge; SE: Standard Edgewise.
Distribution of primary fixed appliance by training and by current usage (by % number of orthodontists). Notes: PEC: Pre-adjusted Edgewise (Conventional Ligation); PESL: Pre-adjusted Edgewise (Self-ligation); T-E: Tip Edge; SE: Standard Edgewise.

Figure 2.

Threshold level of crowding in adults and children/adolescents at which orthodontists are comfortable in carrying out non-extraction treatment (by % number of orthodontists).
Threshold level of crowding in adults and children/adolescents at which orthodontists are comfortable in carrying out non-extraction treatment (by % number of orthodontists).

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_

PatientTreatment approachChange over the past 5–10 years N (%)
MoreLessNo Change
Child/AdolescentExtraction of all first PMs1 (2.4)27 (64.3)14 (33.3)
 Extraction of all second PMs16 (37.2)15 (34.9)12 (27.9)
 Other extractions2 (4.7)9 (20.9)32 (74.4)
 IPR19 (44.2)024 (55.8)
 Transverse expansion19 (45.2)3 (7.1)20 (47.7)
 Incisor proclination18 (41.9)3 (7)22 (51.1)
 Distal movement with TADs12 (29.3)3 (7.3)26 (63.4)
 Combined IPR and arch lengthening24 (55.8)019 (44.2)
AdultExtraction of all first PMs024 (58.5)17 (41.5)
 Extraction of all second PMs8 (20.5)15 (38.5)16 (41)
 Other extractions5 (13.5)9 (24.3)23 (62.2)
 IPR34 (85)06 (15)
 Transverse expansion16 (41)3 (7.7)20 (51.3)
 Incisor proclination20 (50)218
 Distal movement with TADs7 (18.4)4 (10.5)27 (71.1)
 Combined IPR and arch lengthening23 (57.5)1 (2.516 (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 groupFactorInfluence N (%)
MajorModerateMinorNone
Child/AdolescentFacial aesthetics24 (54.54)17 (38.63)1 (2.27)2 (4.58)
 Smile aesthetics18 (40.91)18 (40.91)5 (11.36)3 (6.82)
 TMJ symptoms2 (4.58)3 (6.82)10 (22.73)29 (65.87)
 Appliances used5 (11.36)8 (18.18)18 (40.91)13 (29.55)
 Increased use of IPR6 (13.64)19 (43.18)15 (34.1)4 (9.08)
 Increased use of transverse expansion2 (4.58)17 (38.64)20 (45.55)5 (11.23)
 Periodontal implications14 (32.56)13 (30.23)12 (27.91)4 (9.3)
 Stability due to effect of extractions2 (4.58)12 (27.28)17 (38.5913 (29.55)
 Treatment duration011 (25)23 (52.3)10 (22.7)
 Change in mode of anchorage supplementation2 (4.58)11 (25)18 (40.91)13 (29.51)
 Change in rate of BR use6 (13.64)7 (15.93)10 (22.7)21 (47.73)
AdultFacial aesthetics20 (47.62)17 (40.48)2 (4.76)3 (7.14)
 Smile aesthetics20 (47.62)14 (33.33)4 (9.53)4 (9.53)
 TMJ symptoms03 (7.14)10 (23.81)29 (69.05)
 Appliances used6 (14.29)6 (14.29)18 (42.86)12 (28.56)
 Increased use of IPR6 (14.29)18 (42.86)16 (38.1)2 (4.76)
 Increased use of transverse expansion2 (4.76)17 (40.48)19 (45.24)4 (9.52)
 Periodontal implications14 (34.15)12 (29.27)11 (26.83)4 (9.76)
 Stability due to effect of extractions4 (9.52)8 (19.05)17 (40.48)13 (30.95)
 Treatment duration1 (2.4)10 (23.81)25 (50.95)6 (14.29)
 Change in mode of anchorage supplementation2 (4.76)11 (26.2)20 (47.62)9 (21.42)
 Change in rate of BR use6 (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 groupFactorInfluence
MajorModerateMinorNone
Child/AdolescentFacial aesthetics2 (18.19)5 (45.43)2 (18.19)2 (18.19)
 Smile aesthetics2 (18.19)5 (45.43)2 (18.19)2 (18.19)
 TMJ symptoms003 (27.27)8 (72.27)
 Appliances used01 (9.09)1 (9.09)9 (81.81)
 Increased use of IPR009 (81.81)2 (18.19)
 Increased use of transverse expansion003 (27.27)8 (72.73)
 Periodontal implications2 (18.19)3 (27.27)2 (18.19)4 (36.35)
 Stability due to effect of extractions9 (81.81)2 (18.19)00
 Treatment duration03 (27.27)6 (54.54)2 (18.19)
 Change in mode of anchorage supplementation002 (18.19)9 (81.81)
 Change in rate of BR use02 (18.19)6 (54.54)3 (27.27)
AdultFacial aesthetics1 (14.29)02 (28.58)4 (57.16)
 Smile aesthetics1 (14.29)02 (28.58)4 (57.16)
 TMJ symptoms001 (14.29)6 (85.74)
 Appliances used01 (14.29)1 (14.29)5 (71.45)
 Increased use of IPR003 (42.87)4 (57.16)
 Increased use of transverse expansion0007 (100)
 Periodontal implications001 (14.29)6 (85.74)
 Stability due to effect of extractions1 (14.29)4 (57.16)02 (28.58)
 Treatment duration02 (28.58)3 (42.87)2 (28.58)
 Change in mode of anchorage supplementation0007 (100)
 Change in rate of BR use003 (42.87)4 (57.16)

Summary of participant demographic details_

N (%)
Gender 
    Male116 (71.2)
    Female43 (26.4)
    Prefer not to say4 (2.4)
Where specialist qualification acquired 
    Australia139 (85.28)
    New Zealand3 (1.84)
    Other21 (12.88)
Work type 
    Private136 (83.4)
    Public/university and private22 (13.5)
    Public/university2 (1.2)
    Other3 (1.9)
State/Territory of main workplace 
    NSW / ACT49 (30)
    Queensland31 (19)
    South Australia / NT25 (15.33)
    Victoria/Tasmania38 (23.31)
    Western Australia20 (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_

PatientTreatment approachChange over the past 5–10 years N (%)
MoreLessNo change
Child/AdolescentExtraction of all first PMs9 (75)2 (16.7)1 (8.3)
 Extraction of all second PMSs8 (66.6)2 (16.7)2 (16.7)
 Other extractions7 (58.3)2 (16.7)3 (25)
 IPR3 (25)5 (41.7)4 (33.3)
 Transverse expansion04 (33.3)8 (66.7)
 Incisor proclination5 (41.7)3 (25)4 (33.3)
 Distal movement with TADs06 (50)6 (50)
 Combined IPR and arch lengthening06 (50)6 (50)
AdultExtraction of all first PMs3 (30)3 (30)4 (40)
 Extraction of all second PMs6 (60)1 (10)3 (30)
 Other extractions3 (30)25 (50)
 IPR4 (44.4)2 (22.2)3 (33.3)
 Transverse expansion01 (10)9 (90)
 Incisor proclination226 (60)
 Distal movement with TADs05 (50)5 (50)
 Combined IPR and arch lengthening05 (50)5 (50)
DOI: https://doi.org/10.2478/aoj-2022-0013 | Journal eISSN: 2207-7480 | Journal ISSN: 2207-7472
Language: English
Page range: 227 - 236
Submitted on: Jan 1, 2022
Accepted on: Feb 1, 2022
Published on: Jul 6, 2022
Published by: Australian Society of Orthodontists Inc.
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2022 Maurice J. Meade, Craig W. Dreyer, published by Australian Society of Orthodontists Inc.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.