Effects of first premolar extraction on airway dimensions in young adolescents: A retrospective cephalometric appraisal

OBJECTIVE: To evaluate the upper airway dimensions in adolescents treated for bimaxillary proclination with first premolar extraction. MATERIALS AND METHODS: A retrospective cephalometric evaluation was carried out on the available pre and post orthodontic treatment records of 150 patients (12-18 years of age) who had bimaxillary proclination and were treated with fixed orthodontic therapy. Cephalometric landmarks for sagittal airway measurements and hyoid bone were identified; linear and angular measurements were obtained. Descriptive statistics using paired t-test was used to assess changes in pre and post treatment values and Pearson's correlation coefficient was calculated to evaluate the reliability of observations. The method error calculations were performed using the Dahlberg formula. RESULTS: It was observed that the mean values of nasopharyngeal dimension and Total Airway Length (TAL) showed no statistically significant difference in pre and post treatment groups. All other airway and hyoid parameters showed statistically significant difference. Pearson's correlation coefficient showed statistically significant correlations in all the airway and hyoid parameters. CONCLUSIONS: In the present study, the nasopharyngeal dimension and TAL were not found to be directly affected by the retraction of anterior teeth, This can be attributed to the fact that nasopharyngeal dimension and TAL are not under direct influence of tongue position. The other findings also indicated direct correlation of tongue position to oropharynx and hypopharynx. Consequently, we emphasize clinically relevant anatomic risk factors that should be given prime importance and serious consideration on the decision whether to extract or not in growing patients.