Vertical Gingival Display Changes Associated With Upper Premolars Extraction

Study Overview
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Brief Summary
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To investigate and compare vertical gingival display (VGD) changes associated with upper premolars extraction during orthodontic treatment.

Detailed Description
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Seventy-six subjects who met the inclusion criteria were divided into one of 3 groups according to their treatment modalities as follows: group 1: upper first premolars extraction (24 patients, aged 21.56±3.19 years); group 2: upper second premolars extraction (26 patients, aged 22.16±3.59 years) and group 3: no orthodontic intervention was performed (happy with their teeth) (26 subjects, aged 20.45±3.29 years). Initial records (radiographs, study casts and clinical photographs) were taken for all subjects. The same records were taken post treatment for treated subjects only. The Pre- and post- treatment VGD and lip length in static and dynamic positions and the amount of upper teeth retractions were recorded. The paired t-test and ANOVA test were used to detect treatment changes and differences between studied groups, respectively. Factors affecting VGD were investigated using backward stepwise linear regression analysis.

Official Title
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Vertical Gingival Display Changes Associated With Upper Premolars Extraction Orthodontic Treatment in Gummy Smile Patients: A Prospective Clinical Trial

Conditions
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Gummy Smile, Orthodontic Treatment

Intervention / Treatment
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* Procedure: Upper first premolars extractions
* Procedure: Upper second premolars extraction


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age 17 years or more skeletal class I or class II malocclusion upper premolars extraction treatment plan high smile line 2mm or more no previous orthodontic treatment. Exclusion Criteria: poor oral hygiene lower arch extraction treatment plan smoking Any systemic or periodiontal disease.

Ages Eligible for Study
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Minimum Age: 17 Years
Maximum Age: 28 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Group 1: upper first premolars extraction (24 patients) Group 2: upper second premolars extraction (26 patients) and Group 3: no orthodontic intervention was performed (happy with their teeth) (26 subjects).
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Upper first premolars extraction<br>Included 24 patients (7 males,17 females) with a mean age of 21.56±3.19years who were treated with fixed orthodontic appliance for 2.22±0.31years. | Procedure: Upper first premolars extractions<br>* Fixed orthodontic treatment with upper first premolars extraction and space closure using 0.019X0.025 SS AW and elastic chain.<br>|
| Experimental: Upper second premolars extraction<br>Included 26 patients (8 males,18 females) with a mean age of 22.16±3.59years who were treated with fixed orthodontic appliance for 2.25±0.30 years. | Procedure: Upper second premolars extraction<br>* Fixed orthodontic treatment with upper second premolars extraction and space closure using 0.019X0.025 SS AW and elastic chain.<br>|
| No Intervention: No intervention<br>Included 26 subjects (10 males, 16 females) with a mean age of 20.45±3.29years.This group was included to observe any changes in the vertical gingival display over the 2 years' observation period (1.65±0.17 years). | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The amount of pre- and post-treatment vertical gingival display in static and dynamic positions. | Measured from the lower edge of the upper lip to the gingival margins of the incisors in mm. | 2 years | 
| Pre- and post treatment Nose-U-lip-length | Measured from the soft tissue subnasale to the upper lip stomion (base of the nose to the lip edge of the upper lip) in mm. | 2 years | 
| Upper anterior teeth retraction | The amount of upper anterior teeth edges' retraction on cephalometric superimposition in mm | 2 years | 
| Upper incisors extrusion | The amount of upper incisors edges vertical displacement on cephalometric superimposition in mm | 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Upper molars protraction | The amount of upper molars protraction measured from the mesial contact point of the molar in the baseline model to the mesial contact point of the transposed transparent model(S1) in mm | 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Gingival display, Tooth extraction, Dental esthetics, Corrective orthodontics