Wednesday, October 11, 2017

Department of Pediatric Dentistry
Lutheran Medical Center
            
Resident’s Name: Michael Hatton                       Date: 10/11/2017
Article Title: Dental Arch Space Changes Following Premature Loss of Primary First Molars: A Systematic Review
Author(s): William Tunison BSc, Carlos Flores-Mir DDS DSc, Hossam ElBadrawy DDS MSc, Usama Nassar DDS MSc, Tarek El-Bialy DDS MSc OSci PhD
Journal: Pediatric Dentistry
Date: Jul/Aug 2008
Major TopicGrowth and Development
Type of Article:  Systematic Review
Main Purpose: To perform a systematic review of existing evidence to draw meaningful clinical conclusions concerning the space changes associated with premature loss of primary first molars.
Key Points: 
1)      Immediate space loss of 1.5mm per side in the mandible and 1mm in the maxilla (considering normal growth changes) after loss of primary first molars
2)      There is only a short window after loss of a 1st primary molar for a space maintainer to be effective
 
Conclusions of the article:
1)      Immediate space loss of 1.5mm per side in the mandible and 1mm in the maxilla (considering normal growth changes) after loss of primary first molars
2)      Clinical significance of the loss of space is questionable (but may have treatment implications by case i.e. incisor/lip protrusion or severe arch length deficiencies)
3)      Limited sample sizes and methodological quality of articles (and general lack of good quality and recent articles)
 
Keypoints from the article:
-          Ultimately study is to determine need for space maintenance. 
-          Given studies Kumari and Kumari as well as Cuoghi, the decreased rate of space loss occurs at 4 months post-extraction and most space loss occurs during 1st 6 months, respectively.
-          There is only a short window after loss of a 1st primary molar for a space maintainer to be effective
 

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