Early extraction of the first permanent molars: a five-year follow-up study

Aim Early extraction of first permanent molars (FPMs) is generally considered successful when the second permanent molar and premolar come into contact, regardless of whether the patient has a healthy occlusion. In this study, we aimed to investigate cases in which early extraction had a successful prognosis. Methods Study design: Pre-extraction orthopantomograms of children whose one or more FPMs were extracted were examined retrospectively. Post-extraction parameters such as status of the extraction gap, any other diastema formation, and midline shift were evaluated clinically and radiographically. For the dental age estimations, development levels of the teeth were scored using the Demirjian method and the developmental status of a particular tooth was calculated in years based on tables given by Willems et al. [2001]. The ICON index was used to determine the orthodontic treatment needs of patients. Statistics: Descriptive analyses and the Kruskal-Wallis test were used for the statistical analysis of the data. Results Twenty-six patients with 40 extracted FPM were followed-up for an average of 61.12 months. The mean chronological and dental ages of the patients at the time of extraction were 9.98 +/- 1.35 and 10.65 +/- 1.39 years, respectively. Closure of the extraction gap occurred in 83.3% and 78.5% of the cases in the maxilla and mandible, respectively. However, when the cases with the formation of a diastema between the other teeth and/or midline shift were assumed to have failed, success rates decreased to 50% in the maxilla and 17.8% in the mandible. Conclusions Early extraction of FPM should be considered successful when there is no formation of any other diastema in the relevant quadrant, midline shift, or orthodontic treatment needs due to extraction.