THE EFFECTS OF UNCONTROLLED EXTRACTIONS OF THE PERMANENT LOWER FIRST MOLARS ON THE PROGNOSIS OF SPONTANEOUS SPACE CLOSURE AND OCCLUSION

Yıl 2020, Cilt: 23 Sayı: 3, 181 - 190, 05.10.2020

Melike Kiraz Akif Demirel Mustafa Aydınbelge Şaziye Sarı

https://doi.org/10.7126/cumudj.736127

Öz

Objectives: This cross-sectional study aimed to evaluate the
prognosis of spontaneous space closure and occlusion in uncontrolled permanent
lower first molar extractions in patients with different developmental stages. Materials and Methods: Fifty permanent lower first
molar extractions were included in the study. Extractions were divided into two
groups as appropriate-timing (Group 1- 6th or 7th stages of Nolla) and late-timing
(Group 2- 8th or 9th stages of Nolla), according to the Nolla calcification stage
of permanent second molar germs in the same quadrant. In the 24th month, based
on clinical/radiological/photographic data, the success of spontaneous space
closure, rotation degrees of adjacent teeth, and dental midline deviations were
evaluated. Results: Successful spontaneous space closure was observed in 52%
in Group 1, and no successful result was present in Group 2. The difference was
statistically significant (p<0.001). Rotation results of adjacent teeth were
determined more frequently in Group 2, and the difference was not statistically
significant (p=0.138, p=0.084, p=0.120). Dental midline deviations were
statistically significantly higher in unilateral extractions compared to
bilateral extractions (p=0.006).

Conclusions: The timing of permanent lower first molar
extractions for successful spontaneous space closure should be planned at the sixth
or seventh development stage of the permanent lower second molar, according to
Nolla’s classification. Since rotations in adjacent teeth occur regardless of
extraction timing, cases should be followed-up and intervened if necessary. Besides,
unilateral permanent first molar tooth extractions should be avoided as much as
possible since they cause dental midline deviation.

Anahtar Kelimeler

Dental Occlusion, Malocclusion, Tooth Extraction

Kaynakça

• 1. Rajashekhara BS, Keyur JM, Bhavna D, Poonacha KS. Management of early loss of first permanent molar: A new technique. J Indian Soc Pedod Prev Dent 2012;30:349-51.
• 2. 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.
• 3. Thilander B, Skagius S. Orthodontic sequelae of extraction of permanent first molars. A longitudinal study. Rep Congr Eur Orthod Soc 1970;429-42.
• 4. Mackie IC, Blinkhorn AS, Davies PHJ. The extraction of permanent first molars during the mixed dentition period – a guide to treatment planning. J Paediatr Dent 1989;5:85-92.
• 5. Telli AE, Aytan S. [Changes in the dental arch due to obligatory early extraction of first permanent molars]. Turk Ortodonti Derg 1989;2:138-43.
• 6. Nelson SJ, Ash MM. Development and Eruption of the Teeth, In: Wheeler’s Dental Anatomy, Physiology, and Occlusion, 9th edn. St.Louis, Missouri: Saunders Elsevier, 2010.
• 7. Nolla CM. The development of the permanent teeth. J Dent Child 1960;27:254-66.
• 8. Demirjian A. Tooth eruption in the French Canadian child. J Dent Que 1973;10:9.
• 9. Teo TK, Ashley PF, Parekh S, Noar J. The evaluation of spontaneous space closure after the extraction of first permanent molars. Eur Arch Paediatr Dent 2013;14:207-12.
• 10. 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;151:718-726.
• 11. Gill DS, Lee RT, Tredwin CJ. Treatment planning for the loss of first permanent molars. Dent Update 2001;28:304-8.
• 12. 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.
• 13. 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; discussion 408-9.
• 14. 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.
• 15. Teo TK, Ashley PF, Derrick D. Lower first permanent molars: developing better predictors of spontaneous space closure. Eur J Orthod 2016;38:90-95.
• 16. Sandler PJ, Atkinson R, Murray AM. For four sixes. Am J Orthod Dentofacial Orthop 2000;117:418-34.
• 17. Seddon JL. Extraction of four first molars: a case for a general practitioner? J Orthod 2004;31:80-5.
• 18. Travess H, Roberts-Harry D, Sandy J. Orthodontics. Part 8: Extractions in orthodontics. Br Dent J 2004;196:195-203.
• 19. Ong DC, Bleakley JE. Compromised first permanent molars: an orthodontic perspective. Aust Dent J 2010;55:2-14.
• 20. 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.