Publication Date

5-2025

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Abstract

Premature loss of a primary molar can occur due to a multitude of reasons, including caries, infection, and trauma. When this occurs and restoration of the affected primary tooth is not possible, the AAPD recognizes space maintenance as a “Best Practice” to prevent loss of arch length, width, and perimeter after extraction. However, reports suggest that with proper intercuspation of first permanent molars, space loss from premature loss of a primary molar is minimal and a space maintainer in that area may not be needed. The clinical management for such cases has been controversial across pediatric dental providers, with factors such as timing, behavior, and age all playing large roles in making treatment planning complex. This systematic review is aimed at reviewing the current scientific literature to evaluate the need for a unilateral space maintainer after premature loss of a primary molar in the mixed dentition stage. For sake of completion, studies that looked at loss of first primary molars and/or second primary molars were included. Bilateral space maintenance, such as lower lingual holding arches or Nance appliances, is not investigated in this review due to its relative effectiveness across clinical cases. A systematic review is needed to help guide clinicians’ decision making and provide clarity for management in the currently ambiguous scenario of the premature loss of a primary molar in the mixed dentition stage.

Disciplines

Pediatric Dentistry and Pedodontics

Notes

Presented at the American Academy of Pediatric Dentistry Annual Session; Denver, Colorado; May 22-25, 2025.

Primary Molar Loss and Resulting Space Outcomes: a Systematic Review

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