Prevalence of Missing First Permanent Molars in a Selected Population in a University Dental Clinic Setting: A Retrospective Radiographic Study

Clear aligner treatment of an adult open bite with bilateral missing mandibular first molars through molar protraction with Albert cantilever arms

Premature loss of first permanent molars is a common occurrence in clinical practice, leading to abnormal occlusion and inefficient mastication for patients. This case report presented the orthodontic retreatment of a 32-year-old female patient who suffered from premature loss of mandibular bilateral first molars. The mesial tipping of the mandibular second molars led to an occlusal interference, resulting in a clockwise rotation of the lower jaw and an anterior open bite (AOB). We achieved long-distance molar mesialization using clear aligners with Albert cantilever arms. After 42 months of treatment, the patient's occlusion and facial profile significantly improved. The cantilever combined with the cleat aligner treatment has been clinically effective for the protraction of mandibular posterior teeth, extending the field of application of clear aligners.

Prevalence and Patterns of Positional Dental Anomalies in First Permanent Molars: Insights from a Study in Oradea, Romania

Tooth position anomalies, influenced by both genetic and environmental factors, can significantly impact oral health and play a critical role in establishing proper occlusion. The aim of this study was to identify the most prevalent tooth position anomalies in first permanent molars among Romanian patients and to evaluate additional variables as well. This retrospective study utilized digital study models to identify all existing tooth position anomalies. The study included patients aged 12 to 40 years with complete permanent dentition. Axial changes (buccal tilting, oral tilting, mesial tilting, and distal tilting) as well as rotational changes (mesio-buccal rotation and disto-buccal rotation) were investigated. After applying the exclusion criteria, 103 patients remained in the study. Our findings revealed a notable prevalence of positional anomalies, with disto-buccal rotations being most common in upper molars (tooth 1.6-22.3%, tooth 2.6-31.1%) and oral tilting predominating in lower molars (tooth 3.6-6.8%, tooth 4.6-14.6%). Interestingly, neither gender nor malocclusion type significantly influenced the occurrence of tooth position anomalies. Symmetrical patterns in positional changes were observed, with patients having tooth position anomalies at 1.6 significantly more frequently associated with anomalies at 2.6. Similarly, anomalies at 3.6 were significantly more frequently associated with anomalies at 4.6. Additionally, for molars 2.6 and 3.6 on the left side, the differences were statistically significant, with patients having anomalies at 2.6 significantly more frequently associated with anomalies at 3.6. This pattern was not observed for the molars situated on the right side of the dental arches. While this study provides insights into positional anomalies in first permanent molars among the Romanian population, its retrospective design and focus on a specific demographic may limit generalizability. In conclusion, the study underscores the significant prevalence of positional anomalies in first permanent molars among adolescents and adults in Oradea, Romania. Early detection and targeted interventions are crucial to address these anomalies and improve orthodontic outcomes. Comprehensive assessment and treatment planning are essential to achieve optimal dental harmony and function. Further research is needed to elucidate the underlying factors contributing to these positional changes and their long-term impact on oral health and occlusal stability.

An epidemiological study on early orthodontic treatment need among eastern Saudi Arabian children in the mixed dentition stage

Estimation of early orthodontic treatment need among children is essential for planning orthodontic interventions in the mixed dentition stages thereby reducing the burden in a publicly funded healthcare system. The present study aimed to assess the early orthodontic treatment need among children with mixed dentition in the Eastern Saudi Arabia. A descriptive cross-sectional study was conducted among Saudi children visiting the outpatient clinics in a University dental setting, and data were collected based on Index for preventive and interceptive orthodontic need (IPION). Descriptive statistics, chi-square test and Fisher's exact test were used for data analysis with statistical significance set at p < 0.05. The category of 'no treatment need' accounted for 11.3% while 'moderate treatment need' and 'definite treatment need' categories accounted for 29.3% and 59.4% respectively. There was no statistical difference between males and females in the distribution of the three categories of treatment need (p = 0.513). This study demonstrated a very high need for early orthodontic treatment among Saudi children in the mixed dentition stage. Emphasis should be placed on increased awareness and benefits of seeking early orthodontic treatment involving preventive and interceptive procedures in the mixed dentition.

Permanent First Mandibular Molar: Loss Prevalence and Pattern among Saudis in Al-Ahsa

OBJECTIVES

 The permanent first mandibular molar (PFMM) is the first tooth to erupt, usually at the age of 6 years. It is the most effective oral masticatory unit due to its wide occlusal surface and its role in favorable occlusion. This study describes the prevalence of PFMM loss and the reasons for extraction in a group of King Faisal Dental Complex Clinics (KFUDC) Saudi attendees. In addition, to report postextraction complications, consider the gender, age, and the time elapsed from the moment of the extraction.

MATERIALS AND METHODS

 A cross-sectional study was performed in January to April 2020, focusing on the loss of PFMM among a group of Saudis attending KFUDC in Al Hofuf, Saudi Arabia. A total of 417 participants were recruited. The inclusion criteria were adults aged ≥ 18 years. The principal investigator performed all the necessary measures for calibration in the forms of training on clinical examination and interviews.

STATISTICAL ANALYSIS

 Data were analyzed using the Statistical Package for the Social Science, version 25 (SPSS Inc., Illinois, United States).

RESULT

 Four hundred seventeen attendees participated in the present study. Majority were males 73.9% (308), and 26.1% (109) females. A third, 30% (125), reported missing PFMM; the overwhelming majority reported the reason for extraction as caries 93.6% (117).On clinical examination, 80.8% (101) had complications; drifting of adjacent teeth was the most common complication, 57.6% (72), followed by supraeruption in 23.2% (29).More males than females reported missing PFMM (22.8 and 7.2%, respectively), and those ≥ 25 years reported more missing PFMM than younger (17.5 and 12.5%, p ≤ 0.000). Those confirmed with systemic diseases reported more missing PFMM than their counterpart (23.3 and 6.7%, p ≤ 0.01).Those with good oral hygiene reported less missing PFMM than their poor oral hygiene counterparts (27.8 and 34%). Those who had good knowledge about the complications of early extraction of PFMM stated less missing PFMM than their counterparts (15.6 and 14.4%, p ≤ 0.01).

CONCLUSION

 This study indicated that PFMM were the most common extracted tooth. Caries is the principal reason for tooth extraction among the studied population, followed by periodontal diseases. Emphasis on preventing dental caries is essential to maintain a socially and economically productive life and reduce the burden of oral disease.

Characteristics of Spatial Changes in Molars and Alveolar Bone Resorption among Patients with Loss of Mandibular First Molars: A CBCT-Based Morphometric Study

OBJECTIVES

To investigate the characteristics of spatial changes in molars and alveolar bone resorption among patients with loss of mandibular first molars.

METHODS

A total of 42 CBCT scans of patients with missing mandibular first molars (3 males, 33 females) and 42 CBCT scans of control subjects without loss of mandibular first molars (9 males, 27 females) were evaluated in this cross-sectional study. All images were standardized using the mandibular posterior tooth plane with Invivo software. The following indices regarding alveolar bone morphology were measured, including alveolar bone height, bone width, mesiodistal and buccolingual angulation of molars, overeruption of maxillary first molars, bone defects, and the capability of molar mesialization.

RESULTS

The vertical alveolar bone height in the missing group was reduced by 1.42 ± 0.70 mm, 1.31 ± 0.68, and 1.46 ± 0.85 mm on the buccal, middle, and lingual side, respectively (no differences among the three sides; p > 0.05). Alveolar bone width was reduced the greatest at the buccal CEJ level and the least at the lingual apex level. Mandibular second molar mesial tipping (with mean of the mesiodistal angulation = 57.47 ± 10.34°) and lingual tipping (with mean of the buccolingual angulation = 71.75 ± 8.34°) were observed. The mesial and distal cusps of maxillary first molars were extruded by 1.37 mm and 0.85 mm, respectively. Buccal and lingual defects of alveolar bone occurred at the CEJ, mid-root, and apex levels. Through 3D simulation, the second molar cannot be successfully mesialized into the missing tooth position, and the difference between the available and required distances for mesialization was the greatest at the CEJ level. The duration of tooth loss was significantly correlated with the mesio-distal angulation (R = -0.726, p < 0.001), buccal-lingual angulation (R = -0.528, p < 0.001) and the extrusion of the maxillary first molar (R = -0.334, p < 0.05).

CONCLUSION

Both vertical and horizontal resorption of alveolar bone occurred. Mandibular second molars exhibit mesial and lingual tipping. Lingual root torque and uprighting of the second molars are needed for the success of molar protraction. Bone augmentation is indicated for severely resorbed alveolar bone.

Radiographic Assessment of Permanent First Molars Among Adults in Riyadh: A Retrospective Study

Introduction The first permanent molars (FPMs) are the first permanent teeth to emerge in the oral cavity, which have an important role in dentition, dental development, and occlusion. FPMs are the most susceptible teeth to caries due to early eruption. There are many adverse consequences related to losing FPMs. Many of the previous studies focused on younger age groups. To the best of our knowledge, there needs to be more newly updated data reported in the literature regarding the status of FPMs in adults in Saudi Arabia. The study aimed to assess the status of permanent first molars among adults in a sample of patients in Riyadh. Methods A cross-sectional retrospective study was conducted from the records of patients in the Dental University Hospital, College of Dentistry, King Saud University (KSU), after obtaining ethical approval. Panoramic images of 810 patients ages 18 and above who were seen at KSU, College of Dentistry, were examined to assess the status of FPMs. A panoramic examination was undertaken for various dental reasons in the time between the years 2017 and 2022. Patients were divided into three age groups: 18-30, 31-50, and >50 years. Data were collected in a particular form and analyzed. The prevalence of missing teeth, as well as restored and carious teeth, were recorded. In addition, further information regarding the type of restoration was recorded. Correlations of the findings regarding age, gender, side, and jaw were determined for all cases and were performed using the chi-square test. P-values less than 0.05 were considered statistically significant. Results A total of 810 patients' panoramic radiographs were studied. Panoramic male study subjects were 382 (47.2%), and females were 427 (52.8%). Three-hundred thirty-nine (339; 41.9%) of them were of less than 30 years of age, 327 (40.4%) were in the age group of 31-50 years, and the remaining 144 (17.8%) were above 50 years of age. The prevalence of missing first molar teeth was 145 (17.9%) for teeth 16, 147 (18.1%) for teeth 26, 207 (25.5%) for teeth 36, and 188 (23.2%) for teeth 46. No statistically significant association was found between the age groups and gender and the first molar missing teeth (p=0.848 & p=0.159). Nineteen point thirteen percent (19.13%) of patients had only one missing FPM, 12.3% of patients had two, and 6.29% of them had three missing FPM teeth. Five point fifty-five percent (5.55%) of patients had four missing FPMs. A total of 56.8% (242) radiographs in the overall sample did not show any missing teeth. The mandibular FPMs (35.2%) were found missing more frequently than their maxillary counterparts (14.8%), and the left mandibular quadrant showed a slightly higher rate of missing FPM (25.55%). Statistically, a significant association was seen between the number of missing FPM among different age groups, p-value <0.0001. The most restored, carious, and replaced tooth was the mandibular left molar, and tooth-color restoration was the most commonly used restoration. Conclusion A high prevalence rate of missing first permanent molars (FPMs) was found in this study population. This calls for more awareness and preventive measures to preserve such significant teeth, therefore reducing the need for complex procedures. Further prospective studies on a larger population are needed to comprehensively evaluate the status of FPMs.

Evaluation of Unmet Restorative Treatment Needs among Pediatric Patients of King Faisal University Dental Clinics, Saudi Arabia

Aim

To evaluate unmet restorative treatment needs (URTN) among the children visiting Dental Clinics Complex (DCC), King Faisal University in Al Ahsa region of Eastern Province, Kingdom of Saudi Arabia (KSA).

Materials and methods

A cross-sectional study was conducted among 332 children, 3–13 years old. All the children were grouped based on dentition and gender. Details of patient history, clinical examination, radiographs, and the proposed treatment plan was accessed from Titanium patient management software to assess URTN.

Result

Only 37 children (11.14%) reported to be caries free while the remaining 295 children (88.16%) had one or more carious teeth which needed treatment. Unmet restorative treatment needs were higher for restorable teeth and stainless steel (SS) crown in deciduous dentition group while mixed dentition group showed higher URTN for unrestorable teeth, missing tooth due to caries, filled tooth with caries, remaining root and space maintenance. Based on gender, URTN like restorable teeth and filled tooth with caries were more among girls while missing tooth due to caries and SS crown were more among boys.

Conclusion

Majority of the children had untreated carious teeth. Children in the mixed dentition group showed higher URTN.

Clinical significance

More emphasis on addressing URTN is needed. Improving dental healthcare services to meet the oral healthcare needs, eventually promotes overall quality of life of an individual.

How to cite this article

Alfayz SY, Alabdulsalam M, Alabdulathim A, et al. Evaluation of Unmet Restorative Treatment Needs among Pediatric Patients of King Faisal University Dental Clinics, Saudi Arabia. Int J Clin Pediatr Dent 2022;15(3):366-370.