The effect of premature extraction of primary molars on spatial conditions and formation of malocclusion – a systematic review

Abstract

Introduction: Premature loss of deciduous teeth is considered to be one of the local environmental factors interfering with normal development of the occlusion. Extraction of deciduous tooth before the time of its physio logical exfoliation carries the risk of creation of unfavorable spatial changes in sagittal, transverse and vertical plane. Despite the undeniable role of wellpreserved primary dentition in the development of occlusion in adult hood, there are still controversies regarding indications for implementation of space maintainers. Objectives: Analysis of available literature in terms of consequences of premature loss of deciduous molar teeth. Material and methods: The literature review was conducted in PubMed, EMBASE and Scopus databases in July 2017 basing on keyword "premature primary tooth loss". English and Polishlanguage magazines were taken into account without specifying the time frame. Results: In total, 20 papers were selected for further detailed analysis, of which 11 were based on longitudinal studies, 9 were crosssectional studies (including 7 retrospective studies and 2 systematic literature reviews). Conclusions: Premature extraction of the upper first primary molar may lead to buccal eruption of permanent canine as a consequence of more mesial eruption of first premolar. Increased risk of space loss within dental arch exists especially in case of coexistence of cusp to cusp relationship on first molars and leptoprosopic facial type. Consequences of losing lower first deciduous molar are less obvious. Extraction of second deciduous molars may result in much more serious disturbances related to mesial migration of first permanent molars, resulting in re tention or abnormal eruption of second premolars. Repercussions of early loss of deciduous teeth are often visible only at the moment of eruption of permanent successors and depend on many variables, among which patient's age at the time of extraction, initial spatial conditions (crowding/spacing) and the number and type of lost teeth should be mentioned.

Effectiveness of combined design nance/transpalatal arch appliance in maintaining arch dimensions after premature extraction of primary molars (A randomized controlled clinical trial)

“…It is therefore necessary to insert a SM in the maxillary arch capable of preventing both mesial drift and mesio-palatal rotation of FPMs as soon as possible following the premature loss of maxillary primary molars. (31,32) The combination of both Nance and TPA appliances has been studied by orthodontists for anchorage during the distalization of the anterior section in class II cases. (11)(12) However, this appliance hasn't been the subject of any trials as a SM in the mixed dentition.…”

Knowledge and attitude about the importance of maintaining primary dentition in parents of the Cercado de Lima District

“…Children are often emotionally affected by these problems. Additionally, tooth loss can impair chewing function, speech, and normal occlusion [5] . In such situations, the use of specific removable appliances is recommended to correct these empty spaces and prevent possible speech or tongue interposition disorders.…”

Patterns of balancing and compensating primary tooth extractions amongst paediatric dentists

“…These issues often necessitate complex and extended orthodontic treatments to correct misalignment caused by the shifting of adjacent teeth into spaces left by prematurely extracted teeth. [10][11][12][13] The Faculty of Dental Surgery (FDS) and the Royal College of Surgeons of England (RCSEng) have provided guidelines on the enforced extractions of primary teeth. 8,14 These guidelines assist in determining when balancing or compensating for the enforced extraction of a primary tooth should be considered, aiming to minimize the impact of space loss on the developing dentition.…”