Abstract
BackgroundThe aim of this study was to systematically review the literature to determine the sequelae of early extraction of compromised first permanent molars (FPMs) with regard to the skeletal and dental development of 5- to 15-year-old children. Meta-analysis was conducted when applicable.MethodsOur research protocol included a search strategy, inclusion/exclusion criteria, and a data extraction plan. The search engines used were PubMed, Scopus, and Science Direct. Study selection was performed independently by three reviewers. Articles published from 1960 to 2017 were reviewed based on inclusion and exclusion criteria. Meta-analysis was performed to compare space closure between upper and lower arches.ResultsEleven studies fulfilled the inclusion criteria. The consequences were decrease in post extraction space, accelerated development and eruption of second permanents molars (SPMs) and third molars, a decrease in caries and/or fillings on the proximal surfaces of adjacent teeth, lingual tipping and retrusion of incisors, and counter clockwise rotation of the occlusal plane.ConclusionThere were several consequences of early extraction of FPMs, which were related to skeletal and dental development. Our systematic review suggests that comprehensive evaluation of the compromised FPMs should be performed before planning an extraction. The ideal time for FPM extraction is when the SPM is at the early bifurcation stage in order to achieve complete closure of the extraction space by the SPM. Benefits should be weighed over the risks to decrease the risk of unfavorable outcomes as much as possible. However, due to the limited evidence on the outcomes and variables that influence them, high-quality prospective studies are needed.
Highlights
The aim of this study was to systematically review the literature to determine the sequelae of early extraction of compromised first permanent molars (FPMs) with regard to the skeletal and dental development of 5- to 15-year-old children
The outcomes of early extraction of FPM include a decrease in post extraction space, accelerated development and eruption of the Second permanent molar (SPM) and third molar, a decrease in caries and/or fillings on proximal surfaces of adjacent teeth, lingual tipping and retrusion of incisors, and counter clockwise rotation of the occlusal plane
Where extraction of the FPM is unavoidable, the ideal time to extract should be taken into consideration using the Demirjian classification for development of the SPM rather than by chronological age
Summary
The aim of this study was to systematically review the literature to determine the sequelae of early extraction of compromised first permanent molars (FPMs) with regard to the skeletal and dental development of 5- to 15-year-old children. The first permanent molar (FPM) emerges early, so is more prone to dental caries and possible premature extraction before 15 years of age. The importance of this tooth lies in its major role in maintaining normal masticatory function and dentofacial harmony [3]. Many factors should be considered before determining the appropriate treatment method for a badly decayed FPM, such as the level of crown destruction, the degree of pulp maturation, the status of the developing dentition, the severity of dental pain, the attitude of the child’s parent(s), and the patient’s ability to withstand long treatment under local anesthesia. Extraction of FPMs may be highly considered or not depending on treatment consequences and outcomes [5]
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