Extraction Trends in Orthodontics: Association with Malocclusion and Treatment Planning

Objective: To analyze the frequency of orthodontic dental extractions and provide justification for the decisions made, highlighting the connection between extraction patterns and malocclusion types. Material and methods: Records of 222 patients from the Orthodontics and Dentofacial Orthopaedics Department at Bacha Khan College of Dentistry, Mardan, were retrospectively analyzed over a one-year period. Complete records with thorough treatment plans and extraction choices (except from third molars) were necessary for inclusion. Demographics, extraction patterns, Angle's malocclusion classifications, and the timing of treatment commencement were among the variables evaluated. Associations were assessed using chi-square testing; significance was reached at p < 0.05. Results: The distribution of malocclusions among 222 patients (mean age 18.60 ± 4.57 years; 65.3% female) was Class I (43.7%), Class II (45.0%), and Class III (11.3%). With a maximum of four teeth extracted and an average of 1.43 extracted per patient, extractions were recommended in 45.5% of instances. First premolar extraction was the most prevalent pattern (22.5%). Class II cases had the highest extraction rate (64.0%), and there was a significant correlation (p < 0.001) between the kind of malocclusion and the need for extraction. Conclusion: The study reveals a significant rate of extractions in orthodontic practice, particularly among patients with Class II malocclusion. These findings highlight the necessity of personalized treatment planning and early intervention in orthodontic treatments to improve outcomes and potentially reduce the need for extractions. KEYWORDS:  Frequency, Class II malocclusions, Extractions, orthodontic therapy