EFFECTS AND CLINICAL IMPLICATIONS OF SERIAL EXTRACTIONS IN ORTHODONTICS: A LITERATURE REVIEW

A. Manti¹, A. Torraco¹, C. Maspero^1,2* and L. Giannini^1,2

¹ Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, Milan, Italy;
² Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.

*Correspondence to:
Cinzia Maspero,
Department of Biomedical, Surgical and Dental Sciences,
School of Dentistry,
University of Milan,
20122 Milan, Italy.
e-mail: cinzia.maspero@unimi.it

Received: 16 September, 2025 Accepted: 06 October, 2025

ISSN 2975-044X (online) ISSN 2038-4106 (print) Copyright © by BIOLIFE 2025 This publication and/or article is for individual use only and may not be further reproduced without written permission from the copyright holder. Unauthorized reproduction may result in financial and other penalties. Disclosure: All authors report no conflicts of interest relevant to this article.

ABSTRACT

Background/Objectives: Serial extraction is an interceptive orthodontic procedure used to manage crowding during the mixed dentition phase. This narrative review evaluates the occlusal, skeletal, and functional effects of serial extractions. Methods: A narrative review was conducted by analyzing 11 studies published between 2000 and 2025 that investigated the orthodontic outcomes of serial premolar extractions in growing individuals. Data were extracted on protocols, dental/skeletal outcomes, and long-term results. Results: Serial extractions improved anterior alignment, reduced incisor protrusion, and promoted third molar eruption. The effects were more favorable in Class I cases than in Class II. Vertical control was observed in hypodivergent subjects, with no adverse impact on airway or sleep. Skeletal sagittal changes were minimal. A 50-year follow-up supported the long-term stability of results. Conclusions: When properly indicated, serial extractions provide a safe and effective method for managing dental crowding, facilitating third molar eruption, and achieving functional occlusion, especially in Class I malocclusion. Further standardized studies are needed.

KEYWORDS: Serial extraction, orthodontics, crowding, premolar extraction, third molar eruption, incisor stability, dentoalveolar changes, occlusal plane, airway dimension, pediatric orthodontics