Awareness and Knowledge of Serial Extraction Among General Dentists and Orthodontic Residents in Sana'a City, Yemen

Authors

  • Shehab Y. S. Ghannam University of Science and Technology, Sana’a image/svg+xml
  • Mohammed A. S. Al-Labani University of Science and Technology, Sana’a image/svg+xml

DOI:

https://doi.org/10.59222/ustjms.4.15

Keywords:

Awareness, Knowledge, Serial extraction, Orthodontics, Yemen

Abstract

Background: Serial extraction is an interceptive orthodontic approach that guides tooth eruption, promotes spontaneous alignment, and may reduce the complexity of subsequent orthodontic treatment. Evidence on dental practitioners’ knowledge and awareness of serial extraction in Yemen is limited. This study assessed knowledge and awareness of serial extraction among general dentists and orthodontic residents in Sana’a City and identified associated demographic and professional factors.

Methods: A cross-sectional study was conducted in Sana’a City, Yemen, from July to August 2025 using paper-based and online questionnaires completed by 379 general dentists and 94 orthodontic residents. Knowledge (10 items) and awareness (11 items) were assessed, and associations were examined using chi-square tests and Pearson's correlation, with statistical significance set atP <0.05.

Results: Among 473 respondents, the mean knowledge and awareness scores were 5.56 ± 2.31 and 8.04 ± 2.44, respectively. Overall, 38.1% had good knowledge, whereas 79.7% had high awareness. Correct responses were least frequent for dental cast analysis (23.7%) and the first extraction in Nance’s protocol (37.6%). A large proportion of orthodontic residents had good knowledge (73.4% vs. 29.3%) and high awareness (95.7% vs. 75.7%) compared with general dentists (both P <0.001). Previous experience with serial extraction was associated with better knowledge (P = 0.018) and awareness (P <0.001). Knowledge and awareness scores were positively correlated (r = 0.502, P <0.001).

Conclusion: Among the general dentists and orthodontic residents in Sana'a City, awareness of serial extraction is generally high, but gaps remain in diagnostic space analysis and extraction sequencing. These findings suggest a need to strengthen undergraduate teaching, supervised clinical training, continuing professional development, and specialist referral pathways.

Author Biographies

  • Shehab Y. S. Ghannam, University of Science and Technology, Sana’a

    Department of Biological and Preventive Sciences, Faculty of Dentistry, University of Science and Technology (USTY), Sana'a, Yemen

  • Mohammed A. S. Al-Labani, University of Science and Technology, Sana’a

    Department of Biological and Preventive Sciences, Faculty of Dentistry, University of Science and Technology (USTY), Sana'a, Yemen

References

1. Aldobai NSAM, Al-Harazi G, Al-Haddad K, Alawadi TAM, Alshamrani KK, Al Moaleem MM, et al. Prevalence of oral habits and its association with malocclusion in school children in Yemen. Rom J Stomatol. 2025;71(2):166-72 https://doi.org/10.37897/RJS.2025.2.4

2. Al-Awadi T, Al-Motareb F, Al-Haddad K, Al-Akwa A, Al-Shamahy H. The association between malocclusion and dental caries among Yemeni school children in Sana'a City. Int J Dent Oral Health. 2020;6(6):1-5. https://doi.org/10.52793/JOMDR.2020.2(2)-18

3. Alhadad A, Aldhorae K, Al Moaleem MM, Al-Labani MA, Kofiyh KA, Aljawfi K, et al. Epidemiology of facial profiles, occlusal features, and orthodontic treatment need among adolescence: a cross-sectional study. J Contemp Dent Pract. 2022;23(3):313-9. https://doi.org/10.5005/jp-journals-10024-3258

4. Al-Zubair NM. Orthodontic treatment need of Yemeni children assessed with dental aesthetic index. J Orthod Sci. 2014;3(2):41-5. https://doi.org/10.4103/2278-0203.132913

5. Dewel BF. Serial extraction in orthodontics: indications, objectives, and treatment procedures. Am J Orthod. 1954;40(12):906-26. https://doi.org/10.1016/S0002-9416(54)90043-3

6. Baskaran RNR, Ganapathy D, Subhashree R. Knowledge and awareness of serial extraction among undergraduate students. Biosci Biotechnol Res Commun. 2020;13(7):472-6. https://doi.org/10.21786/bbrc/13.7/79

7. Almeida RR, Almeida MR, Oltramari-Navarro PV, Conti AC, Navarro R, Souza KR. Serial extraction: 20 years of follow-up. J Appl Oral Sci. 2012;20(4):486-92. https://doi.org/10.1590/S1678-77572012000400016

8. Al-Dulaimy DA, Al-Zubaydi FS, Al-Khannaq MRA, Nahidh M. Pedodontists' awareness of orthodontics: an online survey. J Orthod Sci. 2024;13:1. https://doi.org/10.4103/jos.jos_125_23

9. Jyosthna A, Karthikeyan P, Kannan P, Faizee SH, Dhayananth X. Knowledge and awareness of early age orthodontic treatment among interns, general dentists and dental practitioners. J Res Med Dent Sci. 2024;12(1):1-8.

10. Nagrale R, Kadu N, Mulla A, Prabhu O, Khan A. Knowledge, attitude, and awareness of private practitioners in Pune relating to interceptive orthodontic intervention. J Adv Med Dent Sci Res. 2023;11(10):55-60.

11. Chandnani P, Bibi SN, Khan MH, Shar MK, Ullah A, Rana ZA. Awareness of interceptive orthodontics among the dentists serving at Pakistan Institute of Medical Sciences Islamabad. Med Forum Mon. 2022;33(4):41-5.

12. British Orthodontic Society. Managing the developing occlusion: a guide for dental practitioners [Internet]. British Orthodontic Society; 2023. Available from: https://bos.org.uk/wp-content/uploads/2023/05/Managing-the-Developing-dentition-2023-1.pdf (Accessed 20 Oct 2026)

13. Dean AG, Sullivan KM, Soe MM. OpenEpi: open-source epidemiologic statistics for public health, version 3.01. OpenEpi. Available from: https://www.openepi.com/ (Accessed 15 Jul 2025).

14. Jadhav HC, Prashanth VK, Patil SS, Ugale A, Uchil S, Khairnar MR. Awareness of parents toward preventive dentistry in North Maharashtra: a cross-sectional survey. J Indian Assoc Public Health Dent. 2024;22(2):120-3. https://doi.org/10.4103/jiaphd.jiaphd_235_23

15. Brouwer H. Child dental care and serial extraction: a long-term survey. Br J Orthod. 1986;13(3):135-45. https://doi.org/10.1179/bjo.13.3.135

16. Joshi Y, Ambashikar V, Warpe S, Chandak S, Mohammed A. A survey of orthodontic practice in mid western India. SVOA Dent. 2021;2(6):271-83.

17. Alharbi KE, Alharbi IF, Kolarkodi SH. Parental acceptance, knowledge, and awareness toward interceptive orthodontic treatment in children in Saudi Arabia: an online survey. Int J Med Dev Ctries. 2022;6(2):286-92. https://doi.org/10.24911/IJMDC.51-1637171799

18. Dipalma G, Inchingolo AD, Inchingolo AM, Piras F, Carpentiere V, Garofoli G, et al. Artificial intelligence and its clinical applications in orthodontics: a systematic review. Diagnostics (Basel). 2023;13(24):3677. https://doi.org/10.3390/diagnostics13243677

19. Sekaran U, Bougie R. Research methods for business: a skill-building approach. 7th ed. Chichester: John Wiley & Sons; 2016.

20. Taber KS. The use of Cronbach's alpha when developing and reporting research instruments in science education. Res Sci Educ. 2018;48(6):1273-96. https://doi.org/10.1007/s11165-016-9602-2

21. Tavakol M, Dennick R. Making sense of Cronbach's alpha. Int J Med Educ. 2011;2:53-5. https://doi.org/10.5116/ijme.4dfb.8dfd

22. Hotz RP. Guidance of eruption versus serial extraction. Am J Orthod. 1970;58(1):1-20. https://doi.org/10.1016/0002-9416(70)90125-9

23. Fricker J, Kharbanda OP, Dando J. Orthodontic diagnosis and treatment in the mixed dentition. In: Cameron AC, Widmer RP, editors. Handbook of pediatric dentistry. 4th ed. Mosby; 2013. p. 409-45. https://doi.org/10.1016/B978-0-7234-3695-9.00014-6

24. Chalakkal P, de Ataide IdN, Akkara F, Malhotra G. Modified serial extraction in a case with missing mandibular second premolars and a brief review of related treatment modalities. J Indian Soc Pedod Prev Dent. 2013;31(2):126-31. https://doi.org/10.4103/0970-4388.115719

25. Al Hummayani FM. Modified serial extraction treatment in a patient with congenitally missing lower second premolars. J Orthod Sci. 2015;4(3):92-6. https://doi.org/10.4103/2278-0203.160247

26. Pan Orthodontics. Ortho procedures: serial extraction [Internet]. Edina (MN): Pan Orthodontics; [cited 2026 Oct 20]. Available from: https://www.panorthodontics.com/ procedures-serial-extraction/ (Accessed 20 Oct 2026).

27. Borrie FRP. Interceptive Orthodontics: The Evidence, Current General Dental Practice, and Way Forwards in the UK [dissertation]. Dundee: University of Dundee; 2013.

28. Vignesh KC, Ramsey V, Fathima A, Haridoss S, Manoharan R, Priya J, et al. Perceptions, practices, and challenges of interceptive orthodontics among Indian pediatric dentists: a cross-sectional survey. Cureus. 2025;17(12):e98342. https://doi.org/10.7759/cureus.98342

29. Patano A, Malcangi G, Inchingolo AD, Garofoli G, De Leonardis N, Azzollini D, et al. Mandibular crowding: diagnosis and management-a scoping review. J Pers Med. 2023;13(5):774. https://doi.org/10.3390/jpm13050774

30. Hassan S, Sahetiya M, Rabb MIU, Wazir MU, Ahsan H, Farrukh M. Precision in planning orthodontic extractions among dental practitioners of Pakistan: a cross-sectional study. J Health Wellness Community Res. 2025;3(12).

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2026-11-06

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