Spontaneous Second Molar Migration After MIH-Affected First Molars Extraction: A Radiographic-Based Method...

Area of Science:

• Dentistry
• Orthodontics
• Radiology

Background:

• Molar-incisor hypomineralization (MIH) presents significant dental challenges, often necessitating first permanent molar (FPM) extraction in severe cases.
• Assessing spontaneous second permanent molar (SPM) mesialization post-FPM extraction and identifying influencing factors remain underexplored areas.

Purpose of the Study:

• To evaluate novel radiographic methods for assessing spontaneous SPM mesialization after FPM extraction.
• To identify clinical and developmental factors correlated with complete space closure following FPM extraction.

Main Methods:

• Analysis of Orthopantomograms (OPTs) from 19 patients undergoing FPM extraction due to MIH.
• Application of novel geometric measurements to quantify SPM movement pre- and post-extraction.
• Evaluation of factors including age, developmental stage (Demirjian index), observation period, and third permanent molar (TPM) presence.

Main Results:

• Complete or near-complete SPM mesialization observed in 78.6% of maxillary and 73.7% of mandibular sites.
• Maxillary SPMs demonstrated more favorable spontaneous movement, including significant uprighting and higher rates of space closure.
• SPM developmental stages D-E were associated with successful mesialization outcomes.

Conclusions:

• Early FPM extraction is an effective strategy for promoting SPM mesialization, particularly in the maxilla.
• The developed radiograph-based measurement method offers high reliability and reproducibility for clinical and research use.
• This novel approach provides a valuable tool for assessing treatment outcomes in MIH patients.