GuREx-MIH: radiographic assessment of eruption patterns of second permanent molars and premolars in 11-year-olds after early extraction of the first permanent molar - a split-mouth trial.
Adnan Hajdarević, Christina Stervik, Nina Sabel, Birgitta Jälevik, Agneta Robertson, Ken Hansen, Emina Čirgić
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引用次数: 0
Abstract
Background/objectives: Molar-Incisor Hypomineralisation (MIH) affects 14% of the global population, often leading to compromised first permanent molars (FPM). Early extraction of severely affected FPMs may temporarily affect proper eruption and alignment of second permanent molars (SPM) and second premolars (SP). This study aimed to evaluate the eruption patterns of SPMs and SPs, and the overeruption of opposing FPMs, after early FPM extraction using panoramic radiographs in 11-year-old patients. A secondary aim was to assess radiographic quality for these evaluations.
Subjects and methods: This split-mouth trial included patients aged 6-9 with severe MIH requiring FPM extraction. Panoramic radiographs were taken pre-extraction (T0) and at age 11 (T1) to measure eruption length and angulation of SPMs and SPs. Radiographs were analysed using Facad software, and imaging errors were recorded. Paired t-tests compared extraction and non-extraction sides.
Results: Among 47 patients, 31 had maxillary and 25 mandibular FPM extractions. At T0, eruption length and angulation of SPMs and SPs were similar between sides. At T1, maxillary SPMs erupted faster (13.5mm vs. 10.8mm, p < 0.001) and more upright (72.9° vs. 62.1°, p < 0.001) on the extraction side, while SPs showed increased mesial angulation (82.5° vs. 89.3°, p < 0.05). Mandibular SPMs and SPs showed no differences. No overeruption of opposing FPMs was observed. Measurement reliability was excellent (ICC: 0.997-0.999), despite 75 of 94 radiographic contained errors.
Limitations: The three-year follow-up limits long-term insights, and radiographic distortions may affect reliability.
Conclusions: Early FPM extraction impacts maxillary but not mandibular SPM and SP eruption patterns without causing overeruption of opposing FPMs by age 11. Radiographic techniques are essential to minimize incorrect patient positioning, as such factors may impact measurement reliability.
背景/目的：磨牙-门牙低矿化（MIH）影响全球14%的人口，通常导致第一恒磨牙（FPM）受损。早期拔除受严重影响的前磨牙可能会暂时影响第二恒磨牙和第二前磨牙的正常出牙和排列。本研究旨在评估11岁患者早期FPM提取后SPMs和SPs的爆发模式，以及相反FPMs的过度爆发。第二个目的是评估这些评估的放射学质量。受试者和方法：该裂口试验包括6-9岁需要FPM拔牙的严重MIH患者。在拔牙前（T0）和11岁时（T1）拍摄全景x线片，测量spm和SPs的喷发长度和角度。使用Facad软件分析x线片，记录成像误差。配对t检验比较提取侧和非提取侧。结果：47例患者中，上颌31例，下颌骨25例。在T0时，spm和SPs两侧的喷发长度和角度相似。T1时，上颌SPMs爆发速度更快（13.5mm vs. 10.8mm）。局限性：3年随访限制了长期观察，影像学扭曲可能影响可靠性。结论：早期拔牙会影响上颌，但不会影响下颌骨SPM和SP的萌出模式，而不会导致11岁时相反的FPM过度萌出。放射技术对于减少患者不正确的体位至关重要，因为这些因素可能影响测量的可靠性。
期刊介绍：
The European Journal of Orthodontics publishes papers of excellence on all aspects of orthodontics including craniofacial development and growth. The emphasis of the journal is on full research papers. Succinct and carefully prepared papers are favoured in terms of impact as well as readability.
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