Comparative Outcomes of Arch Widening and Extraction Therapies in Managing Mandibular Arch Crowding: An Orthodontic Perspective Original Article
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Abstract
Background: Orthodontic extraction therapy is frequently used to manage mandibular arch crowding. However, its long-term effects on clinical crown length and gingival recession remain unclear, particularly in cases of mild crowding. The present research was design to assess the choice of treatment modality (extraction vs. non-extraction) on the prevalence of labial gingival recession and changes in clinical crown lengths in mandibular anterior teeth.
Methods: A retrospective, longitudinal study was conducted on 70 patients undergoing orthodontic treatment at Albaha University. Patients were divided into extraction (X, n=44) and non-extraction (WE, n=26) groups, ensuring a balanced representation. Inclusion criteria included Angle’s Class I malocclusion with mild to moderate mandibular crowding, and a minimum retention period of three years. Clinical crown lengths were measured with precise digital calipers at three-time points: before treatment (T1), post-debonding (T2), and final retention (T3). Cephalometric analysis was performed with skeletal and dental parameters. Data and the analyzed outcomes were assessed.
Results: Both groups showed a significant increase in clinical crown lengths from T1 to T3 (p < 0.05), with the increase being more pronounced for canines. No statistically significant difference in gingival recession or crown lengthening was observed between the X and WE groups at retention (p = 0.787). Cephalometric variables (D1, D2, and D3) were significantly associated with the extraction decision, particularly at the debonding and retention stages (p < 0.05). However, the vertical cranial morphology did not influence treatment decisions.
Conclusion: There was no significant difference in the development of gingival recession between extraction and non-extraction groups. Extraction therapy was associated with longer treatment duration but did not directly cause increased recession.
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