Impact of proximal cavities and primary molar absence on space in the dental arches

Abstract

Background A recently proposed treatment protocol for dental caries in primary teeth, called Ultra Conservative Treatment (UCT), keeps medium to large cavities open so that children can keep them clean with tooth brushing and fluoride toothpaste. However, carious lesions have been related to malocclusion and decrease of space for the eruption of the permanent successor. Methods This cross-sectional study evaluated dental casts of 235 schoolchildren, aged 6–7 years old of six public schools in deprived suburban areas, and with at least two cavitated dentin carious lesions. The casts were grouped according to the location of cavitated dentin lesions into non-proximal cavity (NPC), proximal cavity with buccal or lingual surface contact point to adjacent tooth (PCCP) and proximal cavity without contact to adjacent tooth (PCWC), as well as the absence of primary molars due carious lesions (PMA). The relationship between location of cavitated dentin lesions or absence of primary molars with C+D+E and D+E space was analyzed. Results Children with absence of primary molars exhibited the smallest C+D+E and D+E space in the maxilla (P < 0.001) and mandible (P < 0.001), followed by proximal cavity without buccal or lingual surface contact. No significant difference was observed between NPC and PCCP groups in upper and lower arches. Discussion PCWC are associated with minor (less than the leeway space) C+D+E and D+E space loss in both arches, and additional space loss is noted when primary molars are prematurely lost. These results may have implications for orthodontic and restorative dental care decisions in children.

Does treating proximal cavities in primary molars non-restoratively affect intra-arch space and alignment of successor teeth negatively? A 4-year longitudinal study

“…Measurements were carried out digitally on standardized occlusal pictures of the plaster casts. The method to obtain the occlusal pictures have been described elsewhere ( Gomide et al, 2020b ).…”

“…It has been suggested that extensive cavities in proximal surfaces of primary teeth are associated with a decrease of space in the primary molar region, known as the D+E space ( Northway & Wainright, 1980 ; Gomide et al, 2020b ). Decrease of the D+E space may have orthodontic implications ( Stahl & Grabowski, 2004 ), since it tends to reduce the available space for the eruption of the permanent canine and the premolars, which may affect alignment of the successor teeth and/or cause tooth impaction ( Northway, 2000 ).…”

Reconsideration of Leeway Space Calculated Using Models from Same Patients at Different Growth Stages

“…The long-term use of a lingual arch increases the risk of dental caries, however 8) . In addition, caries developing at the contact points of deciduous molars results in a greater amount of lost space, leading to malformation of the dentition 7) . It has also been shown that crowding naturally decreases between the period of early mixed dentition and that of the early permanent dentition due to the influence of leeway space and other factors 3) .…”

“…Furthermore, leeway space has been shown to be clinically significant in terms of a range of factors, including normal tooth contact, anterior tooth replacement and tooth axis stability, lateral tooth group facing and cusp fitting, and the first molar occlusal relationship 15) . Because of its importance, leeway space continues to draw attention in the literature 1,3,5,7) .…”

Sobrevida da Hall Technique para restaurar molares deciduos cariados - Uma revisão sistemática e meta-análise de braço único

“…By the time they reach 6 years of age, and their primary dentition is complete, the reported worldwide prevalence of dental caries is 48% (1), making it the 10th most common condition in the world (2). This preventable, biofilm-mediated, lifestyle-driven disease harms children's health and wellbeing (3), impacting negatively on their quality of life, resulting in pain, early tooth loss along with impaired function, growth, esthetics (4,5) and loss of time at school (6).…”