Early loss of permanent first molar: what factors should be evaluated to achieve best treatment results?


Ugnė Sadauskienė1,2, Guostė Antanavičienė1,2,  Rūta Almonaitienė1,2, Deimantė Ivanauskaitė1,2

1Vilnius University, Faculty of Medicine, Institute of Dentistry;

2Vilnius University Hospital Zalgirio Clinic,

Vilnius, Lithuania



Background and aim: The purpose of this study was to clarify and present factors that should be evaluated in panoramic radiograph when making decision: to close or open the space by orthodontic means after early loss of permanent first molar.

Materials and methods: Seven panoramic radiographs (4 with early loss of maxillary first molar and 3 with missing mandibular first molar) of patients, representing different age groups (11 to 69 years of age) were selected for evaluation from Vilnius University Hospital Zalgirio Clinic database. Anatomical factors that could influence decision making were clarified and analyzed.

Results: Taking into consideration patient’s dental age, the position of maxillary sinus floor, the tilting of second permanent molar, the existing space between second premolar and second molar, the third molar position, case explanation and relevant treatment modality for each case was presented.

Conclusion: Authors concluded that the position of maxillary sinus floor and patient’s dental age are the key factors that should be evaluated when making clinical decision in the maxilla and mandible respectively. But it is essential to keep all other anatomical factors in mind and respect their relation to each other when planning treatment for patients with prematurely lost first permanent molars.

Keywords: prematurely loss of permanent first molar, orthodontic treatment, panoramic radiography, maxillary sinus, dental age.