ABSTRACT
Aim: The aim of this study was to evaluate the dental arch spatial changes in maxillary and mandibular arches after premature loss of primary molars. Introduction: Primary teeth must be maintained during the change from primary to mixed and then permanent dentition, to preserve and maintain the dental arch. When this normal process is disturbed, usually due to severe decay requiring extraction before normal exfoliation, it can result in migration of adjacent teeth toward the missing space resulting in decreased arch length and malocclusion in the permanent dentition. Materials and Methods: A comprehensive search was conducted using electronic databases such as PubMed Central, Cochrane Database of Systematic Reviews, Google Scholar, LILACS, and ScienceDirect. The title and abstract were screened to find relevant articles, which were then reviewed in full to see if they were worthy of inclusion. All longitudinal and observational studies that looked at space changes after the loss of primary first or second molars were included. Quality assessment of the studies was done based on the Newcastle-Ottawa scale as all the included studies were non-randomized studies. Results: Four thousand five hundred and seventy-eight articles were identified by screening electronic database and assessed for eligibility, 12 full-text articles were assessed, and 4 full-text articles were excluded as they did not match the inclusion criteria. Thus, eight articles were included in this systematic review. Short term and long term space changes and loss of maxillary and mandibular molars were studied individually. In the short term changes, the distal migration of the primary cuspid towards the missing space within 1 month was attributable to early space changes after premature loss of the mandibular first molar, and the greatest space loss was recorded in the first 3 months after premature loss. After the premature loss of the maxillary first molar, immediate space loss of 1mm was documented due to distal migration of the primary canine. Studies found that space loss was caused by the distal migration of primary canines in the case of mandibular primary first molar loss, and that space loss was larger in the mandibular arch after premature loss of second primary molars. Conclusion: The greatest repercussions occurred during the first 3 months after the deciduous molars were extracted, and a space maintainer was recommended in the majority of cases, mainly when there is premature loss of mandibular second primary molar as it leads to mesial displacement of the first permanent molar.
ABSTRACT
Introduction: Formulating an oral health status which will include oral hygiene index (OHI) exclusively for children, deft index, and the incidence of white spot lesions (WSL) will make it easier for the examiner to assess the current oral health status of a child and help in planning preventive strategies. This index will provide a comprehensive yet quick way to assess the oral health status of children as it includes past caries experience, present oral hygiene status, and future prediction of caries. Materials and Methods: Two hundred children (100 male, 100 female) aged 3–5 years (primary dentition) were included in this study. OHI, recorded index tooth wise and segment wise, deft index, and the WSLs classification were recorded in all the children. Receiver operating characteristics (ROC) curve was used to evaluate the accuracy of recording OHI in children index tooth wise and segment wise. Results: All the three indices were recorded for the 200 subjects, and based on the area under the curve of receiver operating characteristics, it was found that the OHI for primary dentition can be recorded tooth wise or segment wise. Index teeth chosen for primary dentition were labial surfaces of 54, 61, and 64, lingual surfaces of 82, 75, and 85. Conclusion: It includes the past caries experience, present hygiene status, and the future prediction of caries, making it a wholesome index. This cumulative index can be widely used in studies of epidemiology and ensure quicker evaluation during dental health programs in public school systems.