Three-dimensional space changes after premature loss of a maxillary primary first molar

A space maintainer is generally preferred when a primary first molar is lost before or during active eruption of the first permanent molars in order to prevent space loss. However, controversy prevails regarding the space loss after eruption of the permanent first molars.

The purpose of this study was to examine spatial changes subsequent to premature loss of a maxillary primary first molar after the eruption of the permanent first molars.

Thirteen children, five girls and eight boys, expecting premature extraction of a maxillary primary first molar because of caries and/or failed pulp therapy, were selected. Spatial changes were investigated using a three-dimensional laser scanner by comparing the primary molar space, arch width, arch length, and arch perimeter before and after the extraction of a maxillary primary first molar. Also, the inclination and angulation changes in the maxillary primary canines, primary second molars, and permanent first molars adjacent to the extraction site were investigated before and after the extraction of the maxillary primary first molar in order to examine the source of space loss.

There was no statistically significant space loss on the extraction side compared to the control side (P = 0.33). No consistent findings were seen on the inclination and angulation changes on the extraction side.

The premature loss of a maxillary primary first molar, in cases with class I molar relationship, has limited influence on the space in permanent dentition.