Ideal spontaneous space closure after late extraction of permanent first molar teeth

OBJECTIVE: Before they haven't completed its development, permanent first molar(PFM) teeth which have been decayed and treated with root canal therapy is mostly extracted before the child even reaches adult hood. With correct evaluation of patient, these extracted teeth’s space can be ideally closed by permanent second molars(PSM). The aim of the study is to learn under which conditions we can provide ideal closure and occlusion in patients who refer to us in a late stage. MATERIALS AND METHODS: 695 patients aged 6-16 years who had PFM tooth extracted at a Faculty of Dentistry were retrospectively evaluated from the system. 117 patients had their PFM tooth extracted after the ideal age range and 15 of them were found to meet the inclusion criteria. Panoramic films of 21 teeth of 15 patients with spontaneous ideal closure were evaluated before extraction and after eruption of PSM teeth. The contact between the PSM and the second premolar was recorded and intraoral photographs were taken. Rotations in the PSM and second premolars, axis disturbances towards the linguale/buccal, midline deviations in both jaws, TMJ dysfunctions and chewing habits were evaluated. RESULTS: When PFM extraction was performed, PSM development stage was determined as Demirjian G in 19 teeth and H stage in 2 teeth. Tipping was observed in 80%, and rotation in 9.5% of the PSM teeth. Clinically, it has been determined that 85% of the patients don’t notice the PFM deficiency, don’t complain about their teeth and don’t consider orthodontic treatment. CONCLUSIONS: Within the limits of this study, it has been observed that ideal spontaneous space closure and ideal occlusion can be achieved, although it was extracted in late period. In ideal occlusion, rotation or tipping after extraction in late period; permanent third molar presence and eruption pressure were more effective than the eruption direction and angle of the PSM tooth.