Incisor irregularity and dental arch dimensions changes in subjects with different severity of anterior crowding: a 37-year follow-up

BACKGROUND: Occlusal stability is one of the goals of orthodontic treatment, and keeping teeth aligned in the long term is a challenge for the orthodontist. This study aimed to compare the long-term incisors irregularity and dental arches dimensions changes in subjects treated with 4 premolar extractions with different pretreatment Little's irregularity index (LII). The knowledge of long-term outcomes is evidence-based information for the prognosis of future treatments. METHODS: In total, 41 treated subjects were divided into two groups according to mandibular Little irregularity value at pretreatment (mild or severe). The maxillary and mandibular LII, transversal, and longitudinal widths were assessed at pretreatment, posttreatment, and 37-year posttreatment. Chi-square and independent t tests were used for intergroup comparison. RESULTS: The groups presented similar behavior for all stages of maxillary and mandibular arch dimensions changes. Maxillary irregularity was corrected in both groups after treatment, and the alignment was acceptable in the long term. In the mild group, the mandibular incisor irregularity returned to pretreatment values in the long term. The mandibular LII increased in the severe group but did not return to pretreatment values in the long term. CONCLUSIONS: The mild crowding group presented proportionally more relapse of mandibular incisor irregularity than the severe crowding group in the long term. Even so, the correction of mild and severe crowding with the extraction of 4 premolars showed satisfactory results in the long term, even with the presence of maturational changes and relapse.