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Informationen aus Orthodontie & Kieferorthopädie 2015; 47(04): 249-258
DOI: 10.1055/s-0035-1565213
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Extraktion eines unteren Schneidezahnes als kieferorthopädische Therapiemaßnahme: Eine retrospektive Analyse behandelter Fälle mittels Peer Assessment Rating Index (PAR-Index)

Extraction of a Lower Incisor as an Orthodontic Treatment Measure: A Retrospective Analysis of Treatment Outcome in Patients Using the Peer Assessment Rating Index (PAR Index)
N. Schepp
1   Kieferorthopädische Fachpraxis, Aalen
,
J. Hourfar
2   Kieferorthopädische Fachpraxis, Reinheim
› Author Affiliations
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Publication History

Publication Date:
17 December 2015 (online)

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Zusammenfassung

Zielsetzung: Das Ziel der vorliegenden retrospektiven Studie war die quantitative Bewertung der Behandlungsergebnisse unter Einsatz des PAR-Index von Patienten, welche in Verbindung mit der Extraktion eines unteren Frontzahnes therapiert wurden.

Material und Methode: Die Anfangs- und Endmodelle von 24 konsekutiven Frontzahnextraktionsfällen wurden von einem externen kalibrierten Prüfer unter Anwendung des PAR-Indexes bewertet. Zusätzlich wurden die anteriore Bolton-Diskrepanz am Modell und der Wits-Wert im Fernröntgenseitenbild bestimmt. Die Ergebnisse wurden einer statistischen Analyse unterzogen. Statistische Signifikanz wurde bei P<0,05 angenommen.

Ergebnisse: Die durchschnittliche PAR-Reduktion über alle 24 Behandlungsfälle betrug 23,40 Punkte (77,17%). Kein Behandlungsfall musste am Ende der Behandlung in die Kategorie „Worse-no different“ eingeordnet werden. 11 (45%) wurden mit „Improved“ bewertet und 13 (55%) mit „Greatly improved“. Bei vergleichbarem prätherapeutischem PAR-Score war die durchschnittliche PAR-Verbesserung der Patienten mit negativem Overjet signifikant höher als bei den Patienten ohne negativen Overjet. Weder die Variable Bolton-Ratio noch der Wits-Wert korrelierten statistisch signifikant mit der behandlungsassoziierten PAR-Verbesserung.

Schlussfolgerungen: Mittels dieser Behandlungsmodalität können Therapieergebnisse erreicht werden, welche nach PAR-Konvention die Kriterien für eine Behandlung hohen Standards erfüllen. Ein negativer Overjet scheint ein günstiger Anfangsbefund für eine erfolgreiche Frontzahnextraktionsbehandlung zu sein. Eine verantwortungsbewusste Entscheidung für oder wider Extraktion eines mandibulären Inzisivus kann nur anhand eines diagnostischen Setups erfolgen.

Abstract

Objective: The purpose of this retrospective study was to evaluate the treatment outcome in patients treated with the extraction of a lower incisor using Peer Assessment Rating Index (PAR Index).

Materials and Methods: Pre and post treatment dental casts of 24 consecutive patients treated with lower incisor extraction were scored with PAR index by a calibrated external examiner. In addition anterior Bolton discrepancy was determined using the dental cast and Wits-Appraisal was measured on the lateral cephalogram. The results were subject to statistical analysis. Statistical significance was assumed at P<0,05.

Results: Mean reduction in the PAR score of all 24 patients was 23,40 points (77,17%). There was no patient in the “worse–no different” group. 11 (45%) patients were in the “improved” group, whereas 13 (55%) were in the “greatly improved” group. Starting with a similar pretherapeutic PAR score, mean PAR improvement was significantly better in patients with negative overjet than in those patients without negative overjet at the beginning of treatment. Neither Bolton ratio nor Wits appraisal correlated significantly with treatment associated PAR improvement.

Conclusions: Mandibular incisor extraction may provide a high standard treatment outcome according to the PAR index. A negative overjet at the beginning of treatment seems to be favorable regarding the quality of treatment outcome. Clinical decision for and against extraction of a mandibular incisor should be made on an individual basis using set-up models.

Schlüsselwörter

Unterkieferschneidezahn-Extraktion - PAR-Index - Behandlungsergebnis - negativer Overjet

Key words

mandibular incisor extraction - PAR index - treatment outcome - negative overjet
 

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