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Die Bedeutung der Extraktionstherapie für die Stabilität des Behandlungsergebnisses

The role of extraction in stability of orthodontic treatment

  • Klinische Nachuntersuchung
  • Published:
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Zusammenfassung

Seit 55 Jahren basieren die „Ex-Nonex-Debatten“ auf Nachuntersuchungen, die wegen unterschiedlicher Stichproben, Therapiekonzepte und Untersuchungsparameter wenig Vergleichsmöglichkeiten bieten. An den Nachuntersuchungsergebnissen exemplarisch ausgewählter Studien — nach Extraktion von ein bis zwei Inzisiven, von Prämolaren und zweiten sowie dritten Molaren, nach früher und später sowie Serienextraktion — wird gezeigt, daß absolute Langzeitstabilität unabhängig vom Therapie- und Extraktionsmodus nicht zu erwarten ist. Die Kölner Nachuntersuchungsergebnisse erlauben einen optimistischen Ausblick: Unabhängig von Behandlungsart und -zeitpunkt überwiegt relative Stabilität bei der Mehrzahl der Patienten. Als wesentliche Kofaktoren bei den Veränderungen der dentoalveolären und skelettalen Merkmale nach Behandlungsabschluß erwiesen sich der Ausprägungsgrad der Anomalie, der Therapiemodus und -umfang sowie das Behandlungsergebnis. Wenn das Behandlungsziel die anatomischen Grenzen nicht überschreitet, können die therapiebedingten postretentiven Veränderungen reduziert werden.

Summary

Long-term postretention assessment of orthodontically treated cases has been of interest for 5 decades; however, extraction versus nonextraction follow-up studies are difficult to compare without regard to sample structure, therapy concept und different parameters. The results of selected studies — extraction of 1 or 2 incisors, of premolars and of second and third molars, early and late extraction therapy and serial extraction — showed that long-term postretention stability is not a realistic treatment goal. The Cologne long-term records allow optimistic prediction: relative stability has been found in the majority of former patients, irrespective of the kind of treatment and treatment time. Original anomaly, type (extraction/nonextraction) and amount of treatment, and end-oftreatment alignment were found to be major factors influencing dentoalveolar and skeletal post-treatment changes. The conclusion is that therapy-induced post-treatment changes can be reduced by having a treatment goal within the anatomic limits.

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Authors and Affiliations

  1. Poliklinik für Kieferorthopädie der Klinik und Poliklinik für Zahn-, Mund- und Kieferheilkunde der Universität zu Köln, Deutschland

    B. Kahl-Nieke

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Kahl-Nieke, B. Die Bedeutung der Extraktionstherapie für die Stabilität des Behandlungsergebnisses. J Orofac Orthop/Fortschr Kieferorthop 57, 272–287 (1996). https://doi.org/10.1007/BF02197548

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