No significant difference exists between the changes in patients' facial profiles as a result of orthodontic treatment with and without extraction of four premolars in terms of esthetic outcomes, according to a systematic review published in the January issue of The Journal of the American Dental Association.
From: http://www.ada.org/en/publications/ada-news/2017-archive/january/january-jada-looks-at-changes-in-facial-profile-resulting-from-orthodontic-treatment
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