Elective extractions of first permanent molars: a review

Year 2018, Volume: 35 Issue: 2, 56 - 61, 01.03.2018

Melike Kiraz Burcu Nihan Yüksel , Şaziye Sarı

https://doi.org/10.17214/gaziaot.348568

Cited By: 1

Abstract

Permanent first molar teeth possess a
key role in the setting-up of the occlusion, contribute significantly to the chewing
function and serve as a guide for other teeth. However, it is frequently
encountered that permanent first molar teeth are extracted due to the predicted
negative prognoses of caries or developmental defects. As a result of the uncontrolled
extraction of the permanent first molar teeth during the growth and development
period, drifting of adjacent teeth, continued eruption of the opposing teeth
and displacements can be seen. Furthermore, following one-sided extraction,
midline deviations, oppositional tooth eruption, skeletal and dental asymmetry,
unilateral chewing habits, and temporo-mandibular joint disorders may occur. To
prevent these pathological conditions and to maintain the stability of the
occlusal relation, it is necessary to do compensation and balancing extractions
of the permanent first molar teeth on the opposite/symmetric arc, assuming
mesial drag of the permanent second and third molar teeth. With such controlled-extractions,
especially in Class I cases, orthodontic or prosthetic treatments, which may
require extra time, cost and effort, could be prevented and a conceivable
occlusion can be established.

Keywords

Dental occlusion, molar tooth, prognosis, tooth eruption, tooth extraction

Daimi birinci büyük azı dişlerinin kontrollü çekimleri: derleme

Abstract

Daimi birinci büyük azı dişleri, daimi
dişlenmeye ait oklüzyonun kurulumunda kilit rol üstlenmekte, çiğneme fonksiyonuna
önemli derecede katkısı olmakta ve diğer dişlerin sürmesi için rehber görevi görmektedirler. Bu dişlerin, çürük ya da gelişimsel defektlere bağlı
olarak öngörülen olumsuz prognozları nedeniyle mecburen çekildiği durumlarla
sıklıkla karşılaşılmaktadır. Ancak daimi birinci büyük azı dişlerinin büyüme ve
gelişim döneminde yapılan kontrolsüz çekimleri sonucunda kalan dişlerde devrilmeler, yer değiştirmeler ve karşıt arka doğru uzamalar
görülebilmektedir. Tek taraflı çekimleri sonucunda ise; orta hat sapmaları,
karşıt dişte uzama, iskeletsel ve dental asimetri, tek taraflı çiğneme
alışkanlıkları ve temporomandibuler eklem bozuklukları meydana gelebilmektedir.
Bu patolojik durumların engellenmesi ve oklüzal ilişkilerin stabilitesini devam
ettirmek adına, karşıt ark ve/veya arkın diğer tarafındaki birinci büyük azı
dişlerinin kontrollü bir şekilde kompenzasyon ve balans çekimleri yapılarak,
daimi ikinci büyük azı ve takiben üçüncü büyük azı dişlerinin meziale doğru
sürüklenmesi ile uygun bir oklüzal ilişki elde edileceği bildirilmektedir. Özellikle Class I olgularda ideal tedavi planlaması
ile yapılan kontrollü çekimlerin sonucunda ekstra zaman, maliyet ve emek
gerektirebilecek olan ortodontik tedavi ya da protetik tedavileri yapmaktansa,
kabul edilebilir bir oklüzyonun temini mümkün olabilmektedir.

Keywords

Azı dişi, diş çekimi, diş erüpsiyonu, diş oklüzyonu, prognoz

References

• Albadri S, Zaitoun H, McDonnell ST, Davidson LE. Extraction of first permanent molar teeth: results from three dental hospitals. Br Dent J 2007;203:E14:408-9.
• Leppäniemi A, Lukinmaa PL, Alaluusua S. Nonfluoride hypomineralizations in the permanent first molars and their impact on the treatment need. Caries Res 2001;35:36-40.
• Skeie MS, Raadal M, Strand GV, Espelid I. The relationship between caries in the primary dentition at 5 years of age and permanent dentition at 10 years of age-longitudinal study. Int J Paediatr Dent 2006;16:152-60.
• Telli AE, Aytan S. Birinci sürekli azı dişlerinin zorunlu erken çekimine bağlı dental arkta görülen değişiklikler. Türk Ortodonti Dergisi 1989;2:138-43.
• Normando AD, Maia FA, Ursi WJ, Simone JL. Dentoalveolar changes after unilateral extractions of mandibular first molars and their influence on third molar development and position. World J Orthod 2010;11:55-60.
• Thilander B, Skagius S. Orthodontic sequelae of extraction of permanent first molars. A longitudinal study. Rep Congr Eur Orthod Soc 1970;429-42.
• Cağlaroğlu M, Kilic N, Erdem A. Effects of early unilateral first molar extraction on skeletal asymmetry. Am J Orthod Dentofacial Orthop 2008;134:270-5.
• Cobourne MT, Williams A, Harrison M. National clinical guidelines for the extraction of first permanent molars in children. Br Dent J 2014;217:643-8.
• Alkhadra T. A Systematic Review of the Consequences of Early Extraction of First Permanent First Molar in Different Mixed Dentition Stages. J Int Soc Prev Community Dent 2017;7:223-6.
• Wu M, Chen L, Bawole E, Anthonappa RP, King NM. Is there sufficient evidence to support an optimum time for the extraction of first permanentmolars? Eur Arch Paediatr Dent 2017;18:155-61.
• Plint DA. The effect on the occlusion of the loss of one or more first permanent molars. Rep Congr Eur Orthod Soc 1970:329-36.
• Thunold K. Early loss of the first molars 25 years after. Rep Congr Eur Orthod Soc 1970:349-65.
• Teo TK, Ashley PF, Parekh S, Noar J. The evaluation of spontaneous space closure after the extractionof first permanent molars. Eur Arch Paediatr Dent 2013;14:207-12.
• Patel S, Ashley P, Noar J. Radiographic prognostic factors determining spontaneous space closure after loss of the permanent first molar. Am J Orthod Dentofacial Orthop 2017;151:718-26.
• Nolla CM. Development of the permanent teeth. J Dent Child. 1960;27:254-66.
• Ong DC, Bleakley JE. Compromised first permanent molars: an orthodontic perspective. Aust Dent J 2010;55:2-14.
• Williams JK, Gowans AJ. Hypomineralised first permanent molars and the orthodontist. Eur J Paediatr Dent 2003;4:129-32.
• Gill DS, Lee RT, Tredwin CJ. Treatment planning for the loss of first permanent molars. Dent Update 2001;28:304-8.
• Holm U. Problems of compensative extraction in cases with loss of permanent molars. Rep Congr Eur Orthod Soc 1970;409-27.
• Innes N, Borrie F, Bearn D, Evans D, Rauchhaus P, McSwiggan S, Page LF, Hogarth F. Should I extract every six dental trial (SIXES): study protocol for a randomized controlled trial. Trials 2013;14:59.
• Kiliaridis S, Lyka I, Friede H, Carlsson GE, Ahlqwist M. Vertical position, rotation, and tipping of molars without antagonists. Int J Prosthodont 2000;13:480-6.
• Craddock HL, Youngson CC. A study of the incidence of overeruption and occlusal interferences in unopposed posterior teeth. Br Dent J 2004;196:341-8.
• Jälevik B, Möller M. Evaluation of spontaneous space closure and development of permanent dentition after extraction of hypomineralized permanent first molars. Int J Paediatr Dent 2007;17:328-35.
• Crabb JJ, Rock WP. Treatment planning in relation to the first permanent molar. Br Dent J 1971;131:396-401.
• Daugaard-Jensen I. Extraction of first molars in discrepancy cases. Am J Orthod 1973;64:115-36.