Extraction or preservation of deciduous molars in early mixed dentition as an interceptive treatment in agenesis of mandibular premolars in normal occlusion: A systematic review

Abstract

BackgroundApproximately 2.4% to 4.3% of the population has agenesis of the lower second premolars. Two main treatment options have been suggested for this condition: extraction of the deciduous molar in early mixed dentition to get a spontaneous space closure or to preserve the deciduous molar as if it was a permanent tooth. ObjectivesTo systematically evaluate the efficacy and safety of deciduous molar extraction compared with no extraction, in the early mixed dentition (10–11years) in children with normal occlusion and agenesis of mandibular premolars. MethodsA systematic literature search was conducted (August 2017) in Medline, PubMed, Embase, and The Cochrane Library and reference lists. Two authors verified data extraction. The inclusion criteria were defined according to the Patients, Interventions, Controls, Outcome methodology. Only controlled clinical studies were considered. ResultsThe systematic literature review identified 824 records, of which 562 eligible publications remained after removal of duplicates. After screening of titles and abstracts, 553 studies were excluded. Nine articles were read in full text, but none of the articles fulfilled the predetermined Patients, Interventions, Controls, Outcome requirements, precluding meaningful analyses of efficacy or safety. In absence of published data, a knowledge gap was identified. ConclusionsThere are no published studies comparing patient benefits or risks of interceptive extraction of deciduous molars with preserving the deciduous molar as if it was a permanent tooth in children in the early mixed dentition with agenesis of mandibular premolars. Well-designed, longitudinal, prospective controlled studies are needed.