Non-Cochrane · intervention · PM29622000
Consequences of early extraction of compromised first permanent molar: a systematic review.
Saber Afnan M, Altoukhi Doua H, Horaib Mariam F, et al. · BMC oral health · 2018 · PubMed · doi:10.1186/s12903-018-0516-4
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
8
current version
GRADE rated
0
No studies
0
Included studies
19
linked below
No studies 0 · 0%Ungraded 8 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children aged 5 to 15 years at the time of extraction of a first permanent molar due to caries or hypomineralization | Children and adolescents who underwent early first permanent molar extraction (11 studies; ages about 5 to 16 years at extraction) |
| Intervention | Early extraction of a compromised (severely carious or hypomineralized) first permanent molar | Early extraction of compromised first permanent molars (unilateral or bilateral) |
| Comparison | Not specified | Non-extraction controls or contralateral non-extraction sides; maxilla versus mandible where reported |
| Outcomes | Skeletal and dental developmental sequelae of early first permanent molar extraction | Post-extraction space closure; second and third molar development and eruption; caries and/or fillings in adjacent teeth; lower incisor tipping and retrusion; skeletal (occlusal plane rotation, facial height) |
| Study designs | Clinical trial, case-control, cross-sectional, or cohort study designs | Eight cross-sectional, two case-control, and one prospective observational study (11 total; one cross-sectional study excluded from outcome analysis for invalid data) |
| Timing | Not specified | Follow-up varied and was often unclear (e.g., about 1 year in one study; several retrospective record-based studies) |
Search date: May 2015 to 2017 (literature from 1960 to 2017). Databases: PubMed; Scopus; Science Direct
Questions and results
Early extraction of a compromised mandibular first permanent molar vs Contralateral non-extraction side (same patient)
Population: Children aged 5 to 15 years with a compromised first permanent molar
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Development and eruption of the third molar Development and eruption of the third molar appeared accelerated after early first permanent molar extraction in two studies (e.g., eruption OR 2.86, 95% CI 1.37 to 5.96); ungraded. Source: Results: Effect on development and eruption of the third molar; Table 1; Table 3 · same question in other reviews | OR 2.86 [1.37, 5.96] | 2 studies | Ungraded |
Lower incisor inclination (lingual tipping and retrusion) Population: Children (approximately 11 years or older) with compromised mandibular first permanent molars Bilateral lower first permanent molar extraction was associated with lingual tipping and retrusion of the lower incisors in one case-control study; ungraded. Source: Results: Effects on incisors; Table 1; Table 3 · same question in other reviews | Normando and Cavacami: lower incisor lingual tipping (1.NB mean 23.2 vs 28.4 degrees, P = 0.004) and retrusion (P = 0.03) after bilateral lower FPM loss. Table 3: Category III, Class C. | 1 study | Ungraded |
Development and eruption of the second permanent molar Root closure and eruption of the second permanent molar appeared accelerated on the extraction side in a single case-control study; ungraded and not statistically tested. Source: Results: Effect on development and eruption of the second permanent molar; Table 1; Table 3 · same question in other reviews | Root closure and eruption of the second permanent molar were accelerated on the extraction side versus the non-extraction side (Telli and Aytan; not statistically tested). Table 3: Category III, Class C. | 1 study | Ungraded |
Skeletal development (occlusal plane rotation, facial height) Population: Children (approximately 11 years or older) with compromised mandibular first permanent molars Bilateral lower first permanent molar extraction was associated with counter-clockwise rotation of the occlusal plane and a mild decrease in lower anterior face height in one case-control study; ungraded. Source: Results: Effects on skeletal development; Table 1; Table 3 · same question in other reviews | Normando and Cavacami: decreased GnSN angle (P = 0.05), counter-clockwise rotation of the occlusal plane (mean 5.6 vs 12.6 degrees, P = 0.0001), and decreased lower anterior face height (P = 0.048). Table 3: Category… | 1 study | Ungraded |
Caries and/or fillings in adjacent teeth Proximal surfaces (extraction vs FPM present; fewer decayed/filled with extraction) One study found fewer decayed or filled proximal surfaces but more decayed or filled occlusal surfaces in arches with an extracted first permanent molar; ungraded. Source: Results: Caries and/or filling of adjacent teeth; Table 1; Table 3 · same question in other reviews | OR 0.48 [0.33, 0.69] | 1 study | Ungraded |
Post-extraction space (spontaneous space closure / decrease in space) Early extraction of a compromised first permanent molar is followed by variable spontaneous closure of the post-extraction space (about 45.5% to 85.2% of cases); certainty was not GRADE-rated (Shekelle category III). Source: Results: Effects on post extraction space; Table 1; Table 3 · same question in other reviews | Spontaneous space closure ranged from 45.5% to 85.2% overall (maxilla 33.3% to 94%, mandible 50% to 75%). Table 3 conclusion: early extraction of compromised FPM leads to decrease in post extraction space (Category III… | 6 studies | Ungraded |
Extraction of a maxillary first permanent molar vs Extraction of a mandibular first permanent molar
Population: Children aged 5 to 15 years undergoing first permanent molar extraction
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Spontaneous post-extraction space closure Maxilla versus mandible (spontaneous space closure) Spontaneous post-extraction space closure did not differ significantly between the maxilla and mandible (pooled OR 2.06, 95% CI 0.46 to 9.28; 3 studies; I2 = 72%); ungraded. Source: Fig. 2; Results: Effects on post extraction space · same question in other reviews | OR 2.06 [0.46, 9.28] | 3 studies · 107 participants | Ungraded |
Comparison
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Caries and/or fillings in adjacent teeth Occlusal surfaces (extraction vs FPM present; more decayed/filled with extraction) | OR 1.64 [1.35, 2.1] | 1 study | Ungraded |
AMSTAR 2 appraisal
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Partial Yes | Partial Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | Yes | Yes | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: N/A · NRSI: No | NRSI: No · RCT: N/A | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: N/A · NRSI: No | NRSI: No · RCT: N/A | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | No | No | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | No | No | yes |
| Overall | Critically Low | Critically Low | yes |
Included primary studies 19
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Rahhal 2014 matched by author and year (probable) | 1 other review | Post-extraction space (spontaneous space closure / decrease in space) | not extracted yet | not extracted yet |
| Ast et al. 1961 The prevalence of malocclusion, related to dental caries and lost first permanent molars, in a fluoridated city and a fluoride-deficient… DOI:10.1016/0002-9416(62)90114-8 | this review only | not stated | not extracted yet | not extracted yet |
| Ay et al. 2006 Changes in mandibular third molar angle and position after unilateral mandibular first molar extraction DOI:10.1016/j.ajodo.2004.10.010 | this review only | not stated | not extracted yet | not extracted yet |
| Ay et al. 2006 Changes in mandibular third molar angle and position after unilateral mandibular first molar extraction. PMID:16443476 | this review only | Development and eruption of the third molar | not extracted yet | not extracted yet |
| Jalevik and Moller 2007 Evaluation of spontaneous space closure and development of permanent dentition after extraction of hypomineralized permanent first molars. PMID:17683321 | this review only | Spontaneous post-extraction space closure | not extracted yet | not extracted yet |
| Jälevik and Möller 2007 Evaluation of spontaneous space closure and development of permanent dentition after extraction of hypomineralized permanent first molars DOI:10.1111/j.1365-263x.2007.00849.x | this review only | Post-extraction space (spontaneous space closure / decrease in space) | not extracted yet | not extracted yet |
| Normando and Cavacami 2010 A influência da perda bilateral do primeiro molar inferior permanente na morfologia dentofacial: um estudo cefalométrico DOI:10.1590/s2176-94512010000600013 | this review only | Lower incisor inclination (lingual tipping and retrusion) | not extracted yet | not extracted yet |
| Oliver et al. 1988 The relationship between loss of first permanent molar teeth and the prevalence of caries and restorations in adjacent teeth: a study of… DOI:10.1016/0300-5712(88)90026-7 | this review only | not stated | not extracted yet | not extracted yet |
| Oliver et al. 1988 The relationship between loss of first permanent molar teeth and the prevalence of caries and restorations in adjacent teeth: a study of… PMID:3183149 | this review only | Caries and/or fillings in adjacent teeth | not extracted yet | not extracted yet |
| Raducanu et al. 2009 The effect of aqualase and phacoemulsification on the corneal endothelium. PMID:20098310 | this review only | Spontaneous post-extraction space closure | not extracted yet | not extracted yet |
| Rãducanu et al. 2009 matched by author and year (probable) | this review only | Post-extraction space (spontaneous space closure / decrease in space) | not extracted yet | not extracted yet |
| Telli and Aytan 1989 matched by author and year (probable) | this review only | Post-extraction space (spontaneous space closure / decrease in space) | not extracted yet | not extracted yet |
| Telli and Aytan 1989 [Changes in the dental arch due to obligatory early extraction of first permanent molars]. PMID:2489135 | this review only | Post-extraction space (spontaneous space closure / decrease in space) | not extracted yet | not extracted yet |
| Teo et al. 2013 The evaluation of spontaneous space closure after the extraction of first permanent molars DOI:10.1007/s40368-013-0042-7 | this review only | Post-extraction space (spontaneous space closure / decrease in space) | not extracted yet | not extracted yet |
| Teo et al. 2013 The evaluation of spontaneous space closure after the extraction of first permanent molars. PMID:23686558 | this review only | Spontaneous post-extraction space closure | not extracted yet | not extracted yet |
| Teo et al. 2015 Lower first permanent molars: developing better predictors of spontaneous space closure DOI:10.1093/ejo/cjv029 | this review only | not stated | not extracted yet | not extracted yet |
| Teo et al. 2015 Lower first permanent molars: developing better predictors of spontaneous space closure. PMID:25888532 | this review only | Post-extraction space (spontaneous space closure / decrease in space) | not extracted yet | not extracted yet |
| Yavuz et al. 2006 Effects of early loss of permanent first molars on the development of third molars DOI:10.1016/j.ajodo.2005.02.026 | this review only | not stated | not extracted yet | not extracted yet |
| Yavuz et al. 2006 Effects of early loss of permanent first molars on the development of third molars. PMID:17110261 | this review only | Development and eruption of the third molar | not extracted yet | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match).
| Review | Shared studies | Jaccard |
|---|---|---|
| Spontaneous space closure after extraction of permanent first molars in children and adolescents: a systematic review and meta-analysis. (2024) | 1 | 0.03 |