Clinical and Investigative Orthodontics · Published 2026-06-22 · DOI 10.1080/27705781.2026.2693417
Amritha Nehru, Shweta Nagesh
Purpose The study aims to compare the changes in nasolabial fold appearance after four first bicuspid extractions in female patients above and below 30 years.Materials and methods The study evaluated retrospective photographs of 47 female patients, divided into two: Group A (<30 years) and Group B (>30 years). All participants underwent extraction of all four first bicuspids as a part of their orthodontic management. Standardized pre-treatment and post-treatment extraoral photographs were evaluated by seven calibrated orthodontists using the Modified Fitzpatrick Wrinkle Scale (MFWS), Wrinkle Severity Assessment Scale (WSRS) and Global Aesthetic Improvement Scales (GAIS). The Wilcoxon signed-rank test was used to compare pre-trey atment and post-treatment MFWS and WSRS scores within each age group. The Mann–Whitney U test was applied to compare the scores between the groups. One way Analusis of Covariance (ANCOVA) and ordinal logistic regression was used to analyse the impact of age on the GAIS scores.Results Group A showed minimal, non-significant change in the NLF severity (MFWS change: +0.036, p = 0.403; WSRS change: +0.146, p = 0.332). Group B demonstrated significant improvement in NLF appearance (MFWS change: −0.457, p < 0.001; WSRS change: −0.761, p < 0.001). About 83% of Group B showed aesthetic improvement compared to 50% in Group A. Ordinal logistic regression indicated that Group B patients were approximately five times more likely to show improved or stable NLF appearance (OR = 5.04).Conclusion Significant age-related differences exist in NLF response to extraction therapy. Older adult females (>30 years) with bidental proclination are more likely to experience improvement in NLF appearance following four first bicuspid extractions compared to younger adults.
Abstract from DOAJ. Public domain (CC0 1.0).
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Nehru, A., Nagesh, S. (2026). Changes in nasolabial folds following orthodontic treatment with four first bicuspid extraction in young and older adult females: an observational study. Clinical and Investigative Orthodontics. https://doi.org/10.1080/27705781.2026.2693417