Objectives: To evaluate the cephalometric effects of premolar extraction on skeletal and dental parameters, and on the soft tissues, in patients subsequently treated with fixed appliances. Prevalence and severity of external apical root resorption due to premolar extraction were also examined.Materials and methods: The dental records of 79 patients treated with fixed appliances were retrieved (groups: extraction, n = 19; non-extraction, n = 60). Pre- and post-treatment statuses of skeletal, dentoalveolar, and soft tissue variables were analyzed on lateral cephalograms to determine change. Periapical radiographs of the maxillary incisors were assessed for external apical root resorption using the Levander & Malmgren index. The t-test, Mann-Whitney U test, chi-squared test, and Kruskal-Wallis test were used to analyze the data. Significance was set at p < .05.Results: Changes in the protrusion and proclination of the incisors and in lip position were significantly different between the groups. Prevalence of external apical root resorption in the two groups was similar.Conclusions: Our findings suggest that extraction therapy affects dentoalveolar traits but not jaw position, nor the risk of root resorption, in patients treated with fixed appliances