Clinical Evaluation for Space Maintainer after Unilateral Loss of Primary First Molar in the Early Mixed Dentition Stage

Abstract

Background and Objectives: Controversy exists regarding the need for a space maintainer after early unilateral loss of a primary first molar. This study aimed to assess the need for a space maintainer after unilateral loss of a primary first molar in the early mixed dentition period. Materials and Methods. In this cross-sectional study, fifty children between 6 and 8 years who had lost a primary first molar unilaterally later than 6 months ago were randomly selected. Midline deviation, molar and canine relationships at both sides, facial growth pattern, and the amount of space loss were all assessed. Data were analyzed using SPSS version 25 via the one-sample t-test, paired t-test, and linear regression (alpha = 0.05). Results. The mean amount of space loss was 1.36 ± 0.78 mm (1.32 mm in the maxilla and 1.40 mm in the mandible). Time since tooth extraction and facial pattern had significant correlations with space loss P < 0.05 . Conclusion. In this particular age group, it is imperative to precisely assess the related factors such as the facial pattern and time since tooth extraction to decide about the placement of a space maintainer for a prematurely lost primary first molar.

Investigating the Factors Affecting the Need for Unilateral Space Maintainer for First Primary Molars in Late Mixed Dentition

“…Most studies have shown that the loss of space during the first 4–6 months after extraction is associated with the drift of deciduous canine teeth and permanent incisors towards the edentulous spaces in both arches [ 6 , 7 ]. Some studies have reported slight mesial drift of maxillary deciduous second molar teeth [ 8 ]. Some other studies have shown that the space loss might lead to the impaction of permanent canines, especially in the upper jaw [ 9 ].…”

“…Generally, reports indicate that patients in the full primary and mixed dentition periods undergo less space deficiency with proper contacts between the cusps of permanent teeth [ 13 ]. Therefore, some researchers question the need for space maintainers when deciduous first molar teeth are lost prematurely under these conditions [ 8 , 9 , 13 ]. However, in general, maintaining space in children is considered important and recommended in the mixed dentition period [ 14 , 15 ].…”

Guía clínica de elección y uso de mantenedores de espacio fijos en niños menores de 10 años. Revisión de la Literatura

“…Varios artículos llevan un seguimiento del paciente a corto plazo, lo que no permite evaluar la longevidad de los mantenedores, durabilidad de los tratamientos, posibles fracturas y la efectividad en la erupción y acomodamiento de las piezas futuras 12,13,14,15 .…”

Dental arch spatial changes after premature loss of first primary molars: A systematic review and meta-analysis of split-mouth studies

“…Reading of complete texts resulted in the inclusion of 11 studies, 9 longitudinal[9, 15, 31-37] and 2 cross-sectional [13,38]. Among them, there were ve studies on Caucasians [13,31,34,35,38], ve on Mongolians [9,15,32,33,36], and one on a Central European [37] (Table 2). Five studies were excluded because they were non split-mouth (n = 5) or nonunilateral premature loss of a primary rst molar (n = 1) [1,4,14,26,39,40] (Table S1).…”