Search

Objective: To evaluate the correlation between atlas morphology and maxillo-mandibular divergence., Study Design: Cross-sectional, analytic study., Place and Duration of Study: Dental Clinics, The Aga Khan University Hospital, Karachi, Pakistan from February to August 2017., Methodology: Pretreatment lateral cephalograms of 208 subjects, aged 18 to 25 years, were evaluated. The atlas parameters were categorized into atlas dorsum, anteroposterior and ventrum, and measured on View Pro-X software. Various maxillary (FPPP, SNPP and FHPP angles) and mandibular (SNGoGn, saddle, articulare, gonial, sum of posterior and Y-axis angles) parameters were used to evaluate the divergence pattern of the individuals. Mann-Whitney U-test was used to compare atlas and maxillo-mandibular parameters between genders. Spearman correlation was used to correlate atlas and maxillo-mandibular parameters across genders. A p-value <0.05 was considered as statistically significant., Results: Statistically significant differences were found between various atlas and maxillo-mandibular parameters between genders. With atlas dorsum, the saddle angle (r = -0.3) in males; whereas gonial (r = -0.2), Y-axis (r = 0.1) and SNPP (r = -0.2) angles in females showed significant weak correlation. With atlas anteroposterior, saddle (r = -0.2), articulare (r = 0.2), SNPP (r = -0.2) and FHPP (r = -0.3) angles in males showed significant weak correlation. However, only the SNPP angle (r = -0.2) in females showed a significant weak correlation with atlas ventrum., Conclusion: A weak correlation was found between atlas parameters and various maxillo-mandibular angular parameters in both genders. Therefore, atlas morphology cannot be regarded as a good predictor of future maxillo-mandibular divergence pattern.

Objective: To determine and compare the mean dentoalveolar heights (mm) in different vertical and sagittal facial patterns., Study Design: Cross-sectional study., Place and Duration of Study: Orthodontics Clinic, The Aga Khan University Hospital, Karachi, from September to November 2013., Methodology: Subjects, aged 15 - 20 years, having fully erupted first permanent molars and central incisors were included in the study from orthodontic records. The pretreatment cephalographs of subjects were traced manually over an illuminator. The various parameters like angles and dentoalveolar heights were measured and recorded on data collection form. Mean value ± SD for the variables were generated. ANOVAwas used to compare the means of dentoalveolar heights among the vertical and sagittal facial patterns. Post Hoc Bonferroni test was applied to show difference among the three vertical and three sagittal facial patterns. P-value equal to or less than 0.05 was taken as statistically significant., Results: The mean age of subjects was 15.8 ±3.2 years in vertical group and 16.3 ±2.9 years in sagittal group. There was statistically significant difference (p=0.008) for the upper anterior dentoalveolar height (UADH) among vertical groups, with statistically significant difference for UADH between hyperdivergent and normodivergent (p=0.04) and hyperdivergent and hypodivergent (p=0.01) facial patterns., Conclusion: The UADH were significantly greater in the hyperdivergent group as compared to both the normodivergent and hypodivergent groups. The sagittal groups showed no statistically significant difference for dentoalveolar heights.

Objective: To compare the plaque index in patients receiving multi-bracket fixed orthodontic treatment for various factors like age, gender, socio-economic status, brushing practices, meal habits, types of brackets, types of ligations, use of mouthwash and duration of treatment., Study Design: Cross-sectional analytical study., Place and Duration of Study: Orthodontics Clinic, The Aga Khan University Hospital, from September to November 2011., Methodology: Socio-demographic and clinical modalities were defined and recorded for 131 patients having multi-bracket fixed appliances. The plaque index of subjects were recorded according to the Silness and Loe plaque index method. Independent sample t-test was used to see difference in plaque index in factors having two variables. One way ANOVA and Post-Hoc Tukey tests were used to see difference in plaque index in factors having three variables. Kappa statistics was used to assess inter examiner reliability. P-value of ≤ 0.05 was taken to be significant., Results: The sample comprised of 37% males (n = 48) and 63% females (n = 83). The plaque index had statistically significant association with practice of brushing i.e., timing of brushing (p=0.001), method of brushing (p=0.08), type of ligatures (p=0.05) and frequency of visits (p=0.01)., Conclusion: The plaque accumulation is significantly decreased in subjects who brush the teeth twice or more than twice a day and those who brush their teeth after breakfast. The use of interdental brush and stainless steel ligatures had significantly low plaque. Subjects presenting with more frequent appointments of short-period had significantly less plaque.

Transposition is a dental anomaly characterized by the exchange of position between two adjacent teeth, especially in relation to their roots, or development and eruption of a tooth in a position normally occupied by a nonadjacent tooth. Transposition of the maxillary canine and first premolar has a low prevalence in the population and it primarily affects maxillary canines and premolars. The aetiology of the transposition remains unclear, although it has been associated with genetic factors. It may also be related to a combination of localised factors such as malformation of adjacent teeth, tooth agenesis, retention of the deciduous canine and a history of local trauma. If uncorrected, the results are often both functionally and esthetically unsatisfactory. This case report presents treatment of a female patient with complete bilateral transposition of maxillary canine and premolar. The patient was treated orthodontically with non-extraction fixed mechanotherapy by simulation of maxillary first premolar as canine bilaterally.

Objective: To investigate the applicability of Pont's index in estimating the maxillary arch width depending on the sum of mesiodistal dimensions of maxillary incisors., Study Design: Cross-sectional, comparative study., Place and Duration of Study: Dental Clinics, The Aga Khan University Hospital, Karachi, from January 2006 to December 2008., Methodology: A total of 150 subjects were included. All measurements were taken on maxillary study casts by a digital caliper. The premolar arch width was taken from the first premolar of the left side to the right side at the distal end of its occlusal groove. The molar arch width was taken from the maxillary left permanent molar to the same of the right at its mesial pit on the occlusal surface. The combined width of the maxillary incisors was taken at their greatest mesiodistal widths. The predicted arch widths were estimated with the Pont's formula: Premolar width (P) = Sum of Incisor widths/80 x 100 Molar width (M) = Sum of Incisor widths/64 x 100 Incisor diameters and arch widths were described in terms of mean values, standard deviations, and coefficients of variation. Correlation coefficients were computed between observed arch widths and those predicted according to Pont's M and P indices., Results: The mean age was 15.8 ± 1.6 years. Low correlations existed between observed and Pont's predicted arch widths in both premolar (r = 0.364) and molar (r = 0.238) regions. Twenty two percent of interpremolar arch widths and 18% of intermolar arch widths showed differences between -1 mm to 1 mm., Conclusion: Low correlations were found between observed and Pont's predicted arch widths. Pont's index is unlikely to be clinically useful as a true predictor of arch width.

Objective: To determine the effect of altered lip line on attractiveness and to find preferred lip line for vertical face types in both genders., Study Design: Cross-sectional analytical study., Place and Duration of Study: The Aga Khan University Hospital, Karachi, from May to July 2009., Methodology: Photographs of two selected subjects were altered to produce three face types for the same individual with the aim of keeping the frame of the smile constant. Lip line was then altered for both the subjects as: both dentitions visible, upper incisors visible, upper incisors and 2 mm gum and 4 mm gum visible. The pictures were rated by different professionals for attractiveness. Descriptive statistics for the raters and multiple factor ANOVA was used to find the most attractive lip line., Results: The total number of raters was 100 with the mean age of 30.3 ± 8 years. The alterations in the smile parameters produced statistically significant difference in the attractiveness of faces, whereas the perception difference was found to be insignificant amongst raters of different professions. Preferred lip line was the one showing only the upper incisors in dolico and mesofacial male and female genders whereas 2 mm gum show was preferred in brachyfacial subjects., Conclusion: The variability in lip line showed significant difference in the perceived attractiveness. Preferred lip lines as the one showing only the upper incisors in dolico and mesofacial male and female genders whereas 2 mm gum show was preferred in brachyfacial subjects.

Objective: To compare different craniofacial patterns with pharyngeal widths., Study Design: Cross-sectional analytical study., Place and Duration of Study: Orthodontic Clinic at the Aga Khan University Hospital, Karachi, from June 2002 to June 2010., Methodology: Data were collected using pre-treatment records including orthodontic files and pre-treatment lateral cephalographs of 360 orthodontic patients. The inclusion criteria were subjects of Pakistani origin, aged between 14-20 years and having no pharyngeal pathology or complaints of nasal obstruction at the initial visit. The sample comprised a total of 360 subjects divided into 2 groups: skeletal Class I (n=180) and skeletal Class II (n=180) subdivided according to the vertical pattern into normodivergent, hyperdivergent and hypodivergent facial patterns. Upper and lower pharyngeal airways were measured using McNamara's airway analysis. The intergroup comparison of upper and lower airways was performed with oneway ANOVA and the Tukey test as the second step., Results: There were 172 males and 188 females with average ages of 15.3±1.3 and 15.4±0.8 years respectively. Hyperdivergent facial pattern subjects belonging either to skeletal Class I or Class II malocclusion showed a statistically significant narrow upper pharyngeal airway width as compared to normodivergent and hypodivergent facial patterns. However, no statistically significant difference was found in lower pharyngeal airway widths in sagittal and various vertical facial patterns., Conclusion: Sagittal malocclusion type does not influence upper pharyngeal width. However, hyperdivergent subjects have statistically significant narrower upper pharyngeal width when compared to other two vertical patterns.

Objective: To compare microaesthetics in pre- and post-orthodontic cases, treated with non-extraction and extraction treatment and assessed whether the achieved microaesthetic parameters are comparable to the proposed norms., Study Design: Quasi-experimental study., Place and Duration of Study: Orthodontic Clinic, the Aga Khan University Hospital, Karachi, from January 2005 to December 2009., Methodology: Orthodontic records of 31 cases treated with non-extraction therapy and 26 cases treated with extraction of upper first premolars were selected. Patients were of Pakistani origin, aged between 12 to 30 years. Microaesthetics was assessed by measuring maxillary central incisor crown width-height ratio, connectors between the maxillary anterior sextant, gingival zenith level of the maxillary lateral incisor and golden percentage of the anterior teeth using the patients' plaster models and intraoral frontal photographs. Measurements of the golden percentage were made using the software Adobe Photoshop, whereas all other parameters were measured on the plaster casts using a digital vernier caliper. Paired t-test, independent t-test and one sample t-test were used to make comparisons within the groups, between the groups, and to compare the posttreatment values with the proposed norms, respectively. Statistical significance level was set at p ² 0.05., Results: A statistically significant improvement in the microaesthetic parameters was observed for both extraction and non-extraction subjects (p < 0.05) after orthodontic treatment. Values closer to the proposed norms were achieved more readily in the non-extraction group., Conclusion: Microaesthetics of the smile is improved with orthodontic treatment. It is recommended that greater consideration be given to the microaesthetic parameters of the smile during the finishing stages particularly when utilizing extraction mechanics during orthodontic treatment.

Objective: To determine the dentoalveolar heights (mm) in skeletal class I normodivergent facial pattern and compare the same heights in male and female subjects., Study Design: Cross-sectional observational study., Place and Duration of Study: Orthodontics Clinic, The Aga Khan University Hospital, Karachi, from July to October 2009., Methodology: Eighty one subjects were selected from the orthodontic record at the Aga Khan University Hospital Karachi. The inclusion criteria were an age range of 12 to 30 years and skeletal class I normodivergent facial pattern with exclusion criteria of prior orthodontic treatment, restored teeth and craniofacial anomalies/syndromes. The pre-treatment cephalographs of the patients were traced manually on acetate paper by the principal investigator. The various land marks were marked and the parameters were recorded. Mean and standard deviations were determined. Independent sample t-test was used to find gender dimorphism., Results: The mean age of the sample was 15.8 ± 3.4 years. Mean ANB angle for the entire sample was 2.6° ± 1.2° and for angle SN-MP was 31.5° ± 2.5°. Descriptive analysis presented mean value of upper anterior, upper posterior, lower anterior and lower posterior dentoalveolar heights to be 28.5 ± 2.7 mm, 22.9 ± 2.6 mm, 41.3 ± 2.9 mm and 31.5 ± 3.2 mm respectively. Male subjects had significantly greater mean values for lower anterior and posterior dentoalveolar heights (p=0.02 and 0.05 respectively)., Conclusion: The mean dentoalveolar heights for the skeletal class I normodivergent sample were established. No gender dimorphism was found for upper dentoalveolar heights however, lower anterior and lower posterior were significantly greater in males as compared to females. All the values of dentoalveolar heights for male subjects were greater than female subjects.

Objective: To compare dental arch dimensions and arch forms in various vertical facial patterns., Study Design: Cross-sectional comparative study., Place and Duration of Study: The Aga Khan University Hospital, Karachi, from June 2007 to May 2008., Methodology: Cases of age ranging 13-30 years were reviewed having full complement of teeth (upto second permanent molars) with less than 7 mm crowding. Exclusion criteria included presence of dental anomalies, previous dentoalveolar surgery, trauma or orthodontic treatment and craniofacial syndromes. One hundred cases including 40 normodivergent, 30 hypodivergent and 30 hyperdivergent facial patterns were selected. Occlusograms were made and various arch dimensions were measured. Arch forms were calculated according to ratios of three sagittal to three transverse dimensions., Results: The mean age of the sample was 21 years and 5 months. Significant differences in arch dimensions were found only in maxillary total arch length (p=0.03) and mandibular posterior intermolar width (p=0.04). Wide lower arches were predominant in all face types. Wide upper arches were predominant only in hypo- and hyperdivergent subjects., Conclusion: Statistically significant difference in arch dimensions was found only in maxillary total arch length and mandibular posterior intermolar width. A non-linear relationship was found between arch length and arch width. Wide lower arches were predominant in all face types whereas wide upper arches were predominant in hypo- and hyperdivergent subjects.

Objective: To compare arch forms in various vertical facial patterns and to make arch form guides based on posterior intermolar widths., Study Design: Cross-sectional comparative study., Place and Duration of Study: The Aga Khan University Hospital, Karachi, from June 2007 to May 2008., Methodology: Subjects with age range of 13-30 years were selected having full complement of teeth (upto second permanent molars) with absence of severe crowding (less than 7 mm). Exclusion criteria were presence of dental anomalies, previous dentoalveolar surgery, trauma or orthodontic treatment and craniofacial syndromes. One hundred subjects including 40 normodivergent, 30 hypodivergent and 30 hyperdivergent cases were selected. Occlusograms were made and various arch dimensions were measured. Arch forms were calculated according to ratios of three sagittal to three transverse dimensions., Results: The mean age of the sample was 21 years and 5 months. Differences in arch dimension were found only in maxillary total arch length (p=0.03) and mandibular posterior intermolar width (p=0.04). Wide lower arches were predominant in all face types. Wide upper arches were predominant in only hypo- and hyperdivergent subjects., Conclusion: Wide lower arches were predominant in all face types whereas wide upper arches were predominant in both hypo- and hyperdivergent subjects. A non-linear relationship was found between arch length and arch width; so arch form guides could not be made for specific face types.

Objective: To compare the actual sum of canine and premolars and that predicted from three mixed dentition prediction methods in orthodontic patients at the Aga Khan University Hospital (AKUH), Karachi., Study Design: Cross-sectional comparative study., Place and Duration of Study: Orthodontic clinic at the Aga Khan University Hospital from June 2002 to December 2007., Methodology: Data were collected using pretreatment records including orthodontic files and plaster casts of 121 orthodontic patients. Digital caliper was used to measure the mesiodistal widths of permanent teeth from 1st molar to 1st molar in mandibular arch, and central incisors and 1st molars in maxillary arch. The methods of Tanaka and Johnston, Moyers, and Bernabé and Flores-Mir were used to predict the mesiodistal widths of the canine and premolars. Comparison between the actual and predicted sum of the mesiodistal widths of canine and premolars was made for each prediction method, using paired sample t-test., Results: There were 45 males and 76 females with average ages of 13.3+/-1.3 and 13.4+/-0.8 years respectively. For males statistically significant differences were found for Moyers at the 75th percentile and Bernabé and Flores-Mir method whereas for females only the Bernabé and Flores-Mir's method showed significant results. However, no significant difference was found in both genders for Tanaka and Johnston method., Conclusion: In the studied orthodontic patients for males Moyers 50th percentile and Tanaka and Johnston methods could be used; while for females Moyers 75th percentile and Tanaka and Johnston methods were applicable for mixed dentition analysis.

Objective: To compare changes occurring in the soft tissue profile with orthodontic treatment in extraction versus nonextraction cases, and to determine the hard and soft tissue parameters that show significant correlations to understand the factors influencing the response to tooth movement., Study Design: Quasi-experimental., Place and Duration of Study: Dental Section, The Aga Khan University Hospital, Karachi, from 2005 to 2008., Methodology: Pre- and post-treatment lateral cephalographs of 34 subjects were assessed. For half of the patients (n=17), treatment included the extraction of 4 premolars, whereas the other half were treated by the non-extraction approach. Incisal and soft tissue effects of treatment were analyzed and compared between both groups using the independent sample t-test to assess the degree of change with orthodontic treatment. Pearson's correlation test was used to determine correlation., Results: The extraction group finished with a statistically significant reduction in upper and lower lip procumbency (p=0.004 and 0.021), while the non-extraction group finished with a slight increase in lower lip procumbency (p=0.009) due to significant increase in IMPA (p=0.046). Although the premolar extraction group showed greater soft tissue changes with treatment, post-treatment comparisons showed that both groups finished within the same soft tissue parameters. Pearson's correlation revealed statistically significant correlations between the upper and lower lips and upper and lower incisors (p < 0.01)., Conclusion: The effects of the two types of orthodontic treatment on the facial soft tissues were very similar, indicating that treatment, involving the extraction of premolars, does not have a detrimental effect on facial aesthetics provided the decision to extract is on sound basis and the mechanics are controlled.

Objective: To compare the mean dental maturity amongst three vertical facial patterns (short, average and long anterior facial heights) and also amongst two sagittal facial patterns (skeletal class I and II) in orthodontic patients., Study Design: Cross-sectional analytical study., Place and Duration of Study: The Aga Khan University Hospital, Karachi, from August to October 2008., Methodology: Data was retrospectively retrieved from pretreatment orthodontic records of patients who visited the orthodontic clinic. The sample was divided into three vertical groups, namely short, average and long anterior facial types, and two sagittal groups, namely skeletal class I and II. Dental development was assessed using the Demirjian's system. One way ANOVA and independent sample t-test were used to find any difference in dental maturity amongst vertical and sagittal facial patterns, respectively., Results: There was no statistically significant difference in dental maturity amongst the three vertical facial patterns (p=0.111) and also amongst the two sagittal groups (p=0.975). Statistically significant gender dimorphism (p < 0.001) was seen amongst boys and girls for dental maturity with girls being more advanced than boys in their dental development., Conclusion: Dental maturation in the three vertical and the two sagittal groups showed no statistically significant difference in our studied population sample and thus need no variations in treatment initiation timings. However, girls should be treated earlier as they are dentally more advanced than boys.

Objective: To compare the vertical facial and dental arch dimensional changes occurring with extraction and nonextraction orthodontic treatments., Study Design: Cross-sectional comparative study., Place and Duration of Study: The Aga Khan University Hospital, Karachi during the period 2003 to 2005., Methodology: Data were collected using records of patients who visited the study setting during the study period. Pre- and post-treatment lateral cephalographs and study casts of 81 orthodontic patients (41=non-extraction and 40=premolar extractions) were taken. Variables used for evaluating vertical dimension were Frankfort mandibular plane angle (FMA), facial height (N-Me), facial height ratio (N-ANS/ANS-Me), soft tissue facial height (G' to Me'), soft tissue facial height ratio (G'-Sn'/zn'-Me'), upper first molar to palatal plane and lower first molar to mandibular plane distance, posterior facial height to anterior facial height ratio (PFH/AFH) and Y-axis. Intercanine, interpremolar and intermolar widths and arch depths were also measured. To evaluate the pre-treatment and posttreatment comparison within each group, paired t-tests were used. For pre- and posttreatment comparisons between the extraction and non-extraction groups, independent sample t-tests were used., Results: The mean age was 15.8+/-1.5 years for non-extraction and 15.4+/-1.2 years for the extraction group. There was no significant difference in the vertical dimensional changes between extraction and non-extraction treatments as it increased in both groups. When comparing posttreatment arch dimensions, there was an increase in the maxillary intermolar width in the non-extraction group while the intermolar widths and arch depths decreased in the extraction group in both arches., Conclusion: Vertical dimensional changes showed no significant difference between extraction and non-extraction groups. Intermolar widths and arch depths decreased in both arches in the extraction group while the maxillary intermolar width increased in the non-extraction group.

Objective: To quantitatively evaluate the pattern of dentoalveolar compensation in skeletal class II patients and to find which dentoalveolar parameter compensates the most for this sagittal jaw discrepancy., Study Design: Cross-sectional study., Place and Duration of Study: Dental Section, the Aga Khan University Hospital, Karachi, from January 2005 to March 2006., Methodology: Cephalometric analyses were performed on pretreatment lateral cephalographs of 87 orthodontic patients who met the selection criteria. Various linear and angular measurements were taken. For a quantitative evaluation of dentoalveolar compensation, association was found between various dental and skeletal parameters by correlation analyses. To evaluate which parameter compensates the most, regression and scatters were performed keeping ANB angle as a measure of sagittal jaw discrepancy versus some parameters (SN-OP, A-NP, UI-NA, IIA, LI-OP, LI-SN, LI-FH, LI-MP)., Results: Statistically significant associations were seen between some skeletal and dental parameters. Correlation and regression analyses indicated SN-OP, LI-OP and LI-FH to be the most likely parameters to compensate for underlying sagittal jaw discrepancies., Conclusion: Lower incisor position and occlusal plane inclination in relation to the craniofacial structures are the most likely parameters for compensation in class II sagittal jaw discrepancy, evaluation of which may be helpful in treatment planning and treatment success.

Objective: To compare the seven methods of cephalometric analysis for assessing sagittal jaw relationship and to determine the level of agreement between them., Study Design: Cross-sectional, analytical study., Place and Duration of Study: Dental Section, the Aga Khan University Hospital, Karachi, from January to December 2004., Methodology: Seven methods, describing anteroposterior jaw relationships (A-B plane, ANB, Wits, AXB, AF-BF, FABA and Beta angle) were measured on the lateral cephalographs of 85 patients. Correlation analysis, using Cramer's V-test, was performed to determine the possible agreement between the pair of analyses., Results: The mean age of the sample, comprising 35 males and 50 females was 15 years and 3 months. Statistically significant relationships were found among seven sagittal parameters with p-value < 0.001. Very strong correlation was found between AXB and AF-BF distance (r=0.924); and weak correlation between ANB and Beta angle (r=0.377). Wits appraisal showed the greatest coefficient of variability., Conclusion: Despite varying strengths of association, statistically significant correlations were found among seven methods for assessing sagittal jaw relationship. FABA and A-B plane may be used to predict the skeletal class in addition to the established ANB angle.

Objective: To assess the psychosocial impact of dental aesthetics using the 'Psychosocial Impact of Dental Aesthetics Questionnaire' (PIDAQ) and self-rated Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN)., Study Design: Cross-sectional study., Place and Duration of Study: Dental Section, the Aga Khan University Hospital, Karachi, from August to September 2006., Methodology: Adults with no prior orthodontic treatment were asked to complete a modified version of the 'Psychosocial Impact of Dental Aesthetics Questionnaire' (PIDAQ). A total of four variables including 'Dental Self-confidence', 'Social impact', 'Psychological impact' and 'Perceived orthodontic treatment need' were assessed by a series of statements, whereas dental aesthetics were assessed by the respondents using the IOTN Aesthetic Component (self-rated IOTN-AC). Kruskal-Walli's test was applied to determine significance., Results: The respondents were 120 adults (70 females and 50 males; mean age 25.8 years), all four of the above-mentioned variables measuring psychosocial impact showed positive and significant correlations with the perceived severity of malocclusion as depicted by the Aesthetic Component (AC) of Index of Orthodontic Treatment Need (IOTN), with p-value of less than 0.01 for all variables., Conclusion: The results indicate the strong psychosocial impact of altered dental aesthetics on the emotional state of an individual. The association between self-rated IOTN-AC grading with psychosocial well-being stands established, indicating that the perceived aesthetics of malocclusion may be as significant a factor in determining treatment need as the degree of malocclusion.

Objective: To determine the morphological characteristics affecting extraction decision in Class II Division 1 malocclusion in females., Design: Cross-sectional study., Place and Duration of Study: Dental Section, The Aga Khan University Hospital, Karachi, from June 2002 to June 2004., Patients and Methods: Lateral cephalograms and study casts of 35 female patients having Class II Division 1 malocclusion were taken. Out of those, 13 were treated with 4 premolar extractions while 22 were treated on non-extraction basis. The cephalometric and cast analysis of Aga Khan University Hospital was used., Results: Patients in the extraction group had larger SN-MP, FMA, and LFH: AFH, L1-NB (mm), E plane-LS, E plane-LI, S line-LS, S line-LI, and smaller Z angle. However, the sagittal discrepancy and tooth size arch length discrepancy had no significant difference between the two groups., Conclusion: The vertical dimensions and the upper and lower lip were the key structures to decide about extraction or non-extraction.