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      A Systematic Review of the Consequences of Early Extraction of First Permanent First Molar in Different Mixed Dentition Stages

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          Abstract

          Aims and Objectives:

          The aim of this study was to consider the available evidence regarding early extraction of permanent first molars (PFMs) in different mixed dentition stages that affect the integrity of occlusion and the implications for treatment planning.

          Materials and Methods:

          Electronic database, including PubMed and Science Direct, searches were conducted for available evidence. Key terms used in the search were “extraction,” “ first permanent molar,” and “mixed dentition.”

          Results:

          The initial search identified 56 studies to be related to the review. Although a significant number of published articles had dealt with early extraction of PFM, only three studies had fulfilled the final selection criteria to be considered for this systematic review.

          Conclusion:

          Future active appliance treatment is important after extraction of PFMs with poor prognosis. If such therapy is not needed, consideration should be given to extraction at the ideal developmental age to achieve spontaneous space closure. Each case should be assessed for the need of balancing or compensating extractions to preserve the dental midline and prevent overeruption.

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          Most cited references12

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          Clinical diagnosis of enamel defects: pitfalls and practical guidelines.

          W Kim Seow (1997)
          Changes in enamel during its development are permanently recorded, and commonly present as either demarcated opacity, diffuse opacity, or enamel hypoplasia. Developmental enamel defects may provide clues regarding their aetiology, and this may have application in clinical dentistry, dental epidemiology and anthropology. However, the usefulness of these applications may be hampered by many pitfalls encountered in the detection and diagnosis of developmental enamel defects. The defects may be masked by saliva, dental plaque, and incorrect lighting. In addition, confounding effects of post-eruptive changes such as dental caries, attrition, and traumatic loss of tooth structure may impair the detection of developmental enamel defects. The non-specificity of appearance of enamel defects may make aetiologic diagnosis of enamel hypoplasia difficult. Furthermore, difficulty is often encountered in the relative timing of events in enamel hypoplasia, due to limited data on the chronology of development of the human dentition. In this review, pitfalls in the clinical assessment of enamel defects are discussed, and guidelines to overcome some of these difficulties are presented.
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            Evaluation of spontaneous space closure and development of permanent dentition after extraction of hypomineralized permanent first molars.

            The aim of this study was to evaluate spontaneous space closure, development of the permanent dentition, and need for orthodontic treatment after extraction of permanent first molars due to severe molar-incisor hypomineralization (MIH). Twenty-seven children aged 5.6-12.7 (median 8.2) years had one to four permanent first molars extracted due to severe MIH. Each case was followed up on individual indications 3.8-8.3 (median 5.7) years after extractions. The eruption of the permanent dentition, and space closure were documented by orthopantomograms, casts, photographs, and/or bitewings. Fifteen children were judged to have a favourable spontaneous development of their permanent dentition without any orthodontic intervention. Seven children were or should be subjected to orthodontic treatment for other reasons registered prior to the extraction. Five children were judged to have a treatment at least caused by the extractions, but three of them abstained because of no subjective treatment need. Extraction of permanent first molars severely affected by MIH is a good treatment alternative. Favourable spontaneous space reduction and development of the permanent dentition positioning can be expected without any intervention in the majority of cases extracted prior to the eruption of the second molar.
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              • Article: not found

              Dental arch space changes following premature loss of primary first molars: a systematic review.

              The purpose of this study was to consider the available evidence regarding premature loss of primary molars and the implications for treatment planning.
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                Author and article information

                Journal
                J Int Soc Prev Community Dent
                J Int Soc Prev Community Dent
                JISPCD
                Journal of International Society of Preventive & Community Dentistry
                Medknow Publications & Media Pvt Ltd (India )
                2231-0762
                2250-1002
                Sep-Oct 2017
                18 September 2017
                : 7
                : 5
                : 223-226
                Affiliations
                [1]Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
                Author notes
                Address for correspondence: Dr. Thamer Alkhadra, Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, P. O. Box: 60169, Riyadh 11545, Kingdom of Saudi Arabia. E-mail: thamer@ 123456ksu.edu.sa
                Article
                JISPCD-7-223
                10.4103/jispcd.JISPCD_222_17
                5629848
                b029fd8e-15f1-45c4-a3df-c9cf0d755f91
                Copyright: © 2017 Journal of International Society of Preventive and Community Dentistry

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 18 June 2017
                : 06 July 2017
                Categories
                Review Article

                extraction,malocclusion,permanent first molar,sequelae,space closure

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