Consequences and management of early loss of first permanent molars in children

Introduction
Early loss of first permanent molars in children is a severe problem with numerous consequences and poses a difficult dilemma for a clinician in choosing the most appropriate management. It requires defining a procedure to limit the occurrence of undesirable effects and to create the most favorable conditions for continued proper occlusion development.

Aim
The aim of this study was to present a review of the literature about causes and consequences of early loss of first permanent molars and recommended management to minimize the need for orthodontic treatment in the future.

Material and methods
Literature from the years 1970-2020 was reviewed using the PubMed medical database.

Results
Early loss of first permanent molars affects skeletal growth and further development of dentition and occlusion. It may lead to periodontal complications, abnormal masticatory muscle function, and temporomandibular joint disorders. A number of factors should be taken into account when planning a procedure, such as the condition of a tooth whose extraction is being considered, patient’s dental age, degree of crowding in the anterior and lateral segments, occlusal relations, and presence and condition of other teeth. Additionally, the need for balancing and compensating extractions must be considered.

Conclusions
Early loss of first permanent molars is a major therapeutic problem. Detailed clinical and radiological evaluation is necessary for all patients. In certain cases, it is possible to achieve spontaneous space closure and reduce the need for future orthodontic intervention. Each case must be evaluated individually to determine the management that is most beneficial to a patient.