Radiographic Assessment of Permanent First Molars Among Adults in Riyadh: A Retrospective Study

Introduction The first permanent molars (FPMs) are the first permanent teeth to emerge in the oral cavity, which have an important role in dentition, dental development, and occlusion. FPMs are the most susceptible teeth to caries due to early eruption. There are many adverse consequences related to losing FPMs. Many of the previous studies focused on younger age groups. To the best of our knowledge, there needs to be more newly updated data reported in the literature regarding the status of FPMs in adults in Saudi Arabia. The study aimed to assess the status of permanent first molars among adults in a sample of patients in Riyadh. Methods A cross-sectional retrospective study was conducted from the records of patients in the Dental University Hospital, College of Dentistry, King Saud University (KSU), after obtaining ethical approval. Panoramic images of 810 patients ages 18 and above who were seen at KSU, College of Dentistry, were examined to assess the status of FPMs. A panoramic examination was undertaken for various dental reasons in the time between the years 2017 and 2022. Patients were divided into three age groups: 18-30, 31-50, and >50 years. Data were collected in a particular form and analyzed. The prevalence of missing teeth, as well as restored and carious teeth, were recorded. In addition, further information regarding the type of restoration was recorded. Correlations of the findings regarding age, gender, side, and jaw were determined for all cases and were performed using the chi-square test. P-values less than 0.05 were considered statistically significant. Results A total of 810 patients' panoramic radiographs were studied. Panoramic male study subjects were 382 (47.2%), and females were 427 (52.8%). Three-hundred thirty-nine (339; 41.9%) of them were of less than 30 years of age, 327 (40.4%) were in the age group of 31-50 years, and the remaining 144 (17.8%) were above 50 years of age. The prevalence of missing first molar teeth was 145 (17.9%) for teeth 16, 147 (18.1%) for teeth 26, 207 (25.5%) for teeth 36, and 188 (23.2%) for teeth 46. No statistically significant association was found between the age groups and gender and the first molar missing teeth (p=0.848 & p=0.159). Nineteen point thirteen percent (19.13%) of patients had only one missing FPM, 12.3% of patients had two, and 6.29% of them had three missing FPM teeth. Five point fifty-five percent (5.55%) of patients had four missing FPMs. A total of 56.8% (242) radiographs in the overall sample did not show any missing teeth. The mandibular FPMs (35.2%) were found missing more frequently than their maxillary counterparts (14.8%), and the left mandibular quadrant showed a slightly higher rate of missing FPM (25.55%). Statistically, a significant association was seen between the number of missing FPM among different age groups, p-value <0.0001. The most restored, carious, and replaced tooth was the mandibular left molar, and tooth-color restoration was the most commonly used restoration. Conclusion A high prevalence rate of missing first permanent molars (FPMs) was found in this study population. This calls for more awareness and preventive measures to preserve such significant teeth, therefore reducing the need for complex procedures. Further prospective studies on a larger population are needed to comprehensively evaluate the status of FPMs.