The evaluation of spontaneous space closure after the extraction of first permanent molars. 2013

T K Y Teo, and P F Ashley, and S Parekh, and J Noar
National Dental Centre, 5 Second Hospital Avenue, Singapore, 168938, Singapore, terrytoma@gmail.com.

OBJECTIVE In the UK, first permanent molars (FPMs) of poor prognosis are often planned for extraction so that second permanent molars (SPMs) erupt favourably to replace the FPMs. However, there is little published data to support this treatment strategy. The aim of this study was to assess the success of planned FPM extractions conducted 5 years ago at a dental hospital in London. METHODS Two hundred and thirty-six SPMs from 63 patients were clinically assessed. The position of each SPM was recorded in relation to the second premolar, against patient Angle's classification and SPM radiographic development stage at the time of FPM extraction. METHODS Results were analysed using ordered logistic regression. RESULTS At the time of FPM extraction, only 54 % of SPMs were at the "ideal" stage of development (Demirjian's dental development stage E). Upper and lower arches yielded significantly different results with 92 % of all upper extractions resulting in complete space closure regardless of SPM development stage. Only 66 % of lower FPMs extracted at SPM stage E had complete space closure and no significant relationship was found between lower SPM development stage and its subsequent space closure. Space closure in both arches also appeared independent of patient Angle's classification. CONCLUSIONS Although only over half the patients had FPMs extracted at the "ideal time", this did not appear to influence successful positioning of the upper or lower SPM. More research is required to investigate and confirm which predictive parameters have a significant effect on post-extraction orthodontic development, especially in the lower arch.

UI MeSH Term Description Entries
D008310 Malocclusion Such malposition and contact of the maxillary and mandibular teeth as to interfere with the highest efficiency during the excursive movements of the jaw that are essential for mastication. (Jablonski, Illustrated Dictionary of Dentistry, 1982) Angle's Classification,Crossbite,Tooth Crowding,Cross Bite,Angle Classification,Angles Classification,Bite, Cross,Bites, Cross,Classification, Angle's,Cross Bites,Crossbites,Crowding, Tooth,Crowdings, Tooth,Malocclusions
D008963 Molar The most posterior teeth on either side of the jaw, totaling eight in the deciduous dentition (2 on each side, upper and lower), and usually 12 in the permanent dentition (three on each side, upper and lower). They are grinding teeth, having large crowns and broad chewing surfaces. (Jablonski, Dictionary of Dentistry, 1992, p821) Molars
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001641 Bicuspid One of the eight permanent teeth, two on either side in each jaw, between the canines (CUSPID) and the molars (MOLAR), serving for grinding and crushing food. The upper have two cusps (bicuspid) but the lower have one to three. (Jablonski, Dictionary of Dentistry, 1992, p822) Premolar,Bicuspids,Premolars
D014078 Tooth Eruption The emergence of a tooth from within its follicle in the ALVEOLAR PROCESS of the MAXILLA or MANDIBLE into the ORAL CAVITY. (Boucher's Clinical Dental Terminology, 4th ed) Teething,Eruption, Tooth,Eruptions, Tooth,Tooth Eruptions
D014081 Tooth Extraction The surgical removal of a tooth. (Dorland, 28th ed) Extraction, Tooth,Extractions, Tooth,Tooth Extractions

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