Three-Dimensional Evaluation of Condylar Position and Joint Spaces Following Orthodontic Treatment With Quadruple Premolar Extractions

This study aimed to assess the alterations in the temporomandibular joint among adult patients undergoing orthodontic treatment involving the extraction of four premolars. A cohort of 44 adults, with a mean age of 24.2 years, underwent orthodontic therapy that included quadruple premolar extractions. Cone-beam computed tomography scans were performed before and after the treatment to evaluate the temporomandibular joints. The three-dimensional assessment focused on the condylar position relative to the cranial base and the articular fossa, the axial condylar rotation, and the joint spaces. Notably, a significant posterior shift of the condyle was detected (P≤0.01), averaging a 0.41mm retraction. The posterior joint space narrowed by 0.32mm post-treatment. Additionally, a medial tilt of 0.62° in the condyle's long axis was observed in the frontal plane. No significant changes were recorded for the other condylar positions, rotations, or joint space dimensions. The findings suggest that orthodontic treatment with four premolar extractions may instigate condylar repositioning and rotation. These insights can inform refinements in treatment protocols.