Radiographic Evaluation of Permanent Second Molar Substitution After Extraction of Permanent First Molar: Identifying Predictors for Spontaneous Space Closure.

PURPOSE: The purpose of this study was to investigate pre-extraction variables associated with spontaneous space closure of the perma- nent second molar (PSM) following early extraction of the permanent first molar (PFM), and test an existing prediction model for the mandibular arch as the rates of spontaneous space closure are significantly lower in the mandible compared to the maxilla. METHODS: Pre-extraction panoramic radiographs of 162 patients (138 maxillary and 168 mandibular quadrants) between five and 15 years old at the time of PFM extraction were evaluated. The prediction model was applied to the mandibular quadrants. Postextraction radiographic evaluation was used for outcome assessment, with success defined as the presence of a visible contact between the second premolar and PSM without marginal ridge discrepancy. RESULTS: Success was observed in 82 percent of maxillary quadrants and 51 percent of mandibular quadrants. Maxillary PFM extraction between eight and 10 years or PSM Demirjian stage D or E demonstrated over 90 percent predictive probability for success. Mandibular PFM extraction at age eight years or PSM Demirjian stage D demonstrated 80 percent success. The prediction model did not add a more predictive value than chronological age or PSM Demirjian stage. CONCLUSIONS: The prediction model was not validated in this study population. Chronological age and permanent second molar developmental stage were the primary predictors for successful substitution with the permanent second molar.

Effectiveness of a Preventive Recall Strategy for Children After Dental Rehabilitation with General Anesthesia.

PURPOSE: To test a more frequent preventive recall strategy following full-mouth dental rehabilitation (FMDR) in children with early childhood caries (ECC). METHODS: Patients were randomized into two groups: controls, who were scheduled to return at six-month intervals (6-MR); and the intervention group, who were scheduled to return at three-month intervals (3-MR and 6-MR). At baseline and at each recall, a caries risk assessment (CRA) and dental exam were completed. Analyses followed CONSORT recommendations, resulting in three analyses: intent-to-treat; per-protocol; and an actual recall analysis. RESULTS: Intent-to-treat analysis showed no significant difference in CRA at six months (P>0.7); per-protocol analysis showed borderline significance (P>.08); and actual recall analysis showed a statistically significant difference in CRA at six months (P=.021). For patients with both 3-MR and 6-MR, 44 percent were assessed at a high caries risk level; for patients with only a 6-MR, 72 percent were assessed as a high caries risk level (P=.021). No significant differences were found in caries incidence at six months. CONCLUSIONS: Following full-mouth dental rehabilitation, patients who returned for follow-ups at both three- and six-month intervals had a greater decrease in caries risk level compared to patients seen at six-month follow-up intervals.