Extraction Timing of Heavily Destructed Upper First Permanent Molars

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This panoramic was taken exactly before the extraction of the upper left first molar. Upper right first molar undergone RCT. The expansion appliance was removed and started with fixed orthodontic appliance to level the anterior teeth
This panoramic was taken exactly before the extraction of the upper left first molar.
Upper right first molar undergone RCT. The expansion appliance was removed and started with
fixed orthodontic appliance to level the anterior teeth.

The first permanent molar as the first permanent tooth in the mouth and with a general insufficient oral hygiene of the children, is commonly subject to significant compromise which may arise due to caries or endodontic complication, or from developmental anomalies such as hypoplasia. Compromised teeth with questionable prognosis may result in short- and long-term clinical dilemmas. The aim of this research is to highlight the factors that require careful consideration when a compromised UFPM is detected and the importance of timely UFPM extraction to ensure the mesial drift of the upper second permanent molar (USPM) to fulfill the space of the extracted UFPM without any orthodontic intervention. For this purpose 52 heavily destructed UFPMs were extracted at age of 10.5 years old, 44(84.6%) USPMs erupted exactly distal to the second premolar while only 7 (13.4%) USPMs erupted 1 mm distal to the second premolar. Clinically it is recommended to extract the heavily destructed upper first molars at age of 10.5 years old to ensure the complete closure of the extraction space by the passive mesial drift of upper second permanent molar.

Source:
Open Journal of Stomatology DOI: 10.4236/ojst.2014.43024

Image Credits: Scientific Research Publishing  Medicine & Healthcare , 2014 Vol.4

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