Primary and Early Dentition Treatment

Primary and early Dentition TreatmentThe function of original dentition is to provide mastication, as well as to affirm the occlusion, and to maintain quadruplet for permanent teeth eruption. The primary teeth exfoliation and permanent successors eruption is a physiological process (Rao and Sarkar, 1999). In recent decades thus far by and by the advanced dental c be that increased with intact dentition, early loss of primary teeth still remain a major(ip) occupy (Bach and Manton, 2014). betimes loss of primary teeth result majorly from dental caries. Other causes include trauma, infection, ectopic eruption, sloshed length deficiencies leading to resorption of primary teeth and congenital disorders (Brothwell, 1997). Consequences of early loss of primary teeth includes unwanted tooth migrations of primary or permanent teeth with associated loss of arch length. Deficiency in arch length can lead to malocclusion with crowding, rotations, ectopic eruption, unfavourable molar rel ationship, overbite, overjet, and cross bite (Brothwell, 1997). The problems accompanying with early loss of primary teeth have been a subject of concern in many studies.Early loss of teeth in the primary dentition has different impacts depending on which teeth argon lost, childs age, alert alignment and occlusion (Rock and British Society of Paediatric, 2002). Potential consequences must be considered during the clinical examination and treatment planning to determine whether space aliment is compulsory and what type of space maintainer would be most appropriate (Ngan et al., 1999)Early loss of a primary incisor has little effect uponthe permanent dentition although it does trim downfrom appearance.Early loss of primary canines or molars is moreserious since space loss may follow. In each quadrantthe primary canine and molars unitedly argon larger thanthe succeeding permanent canine and premolars, thedifference in tooth sizes between the two dentitionsbeing the Leeway space 10 . This can be assessedwith middling truth by the size differencebetween head start and entropy primary molars, since theprimary first molar is equal in size to the premolarthat willing replace it, eyepatch the primary siemens molar ismuch larger than the second premolar. For this reasonthe Leeway space is also known as the E space.Extraction of a primary canine or molar maycause mesial be a cat of teeth behind the space anddistal drift of anterior teeth, with resultant displace-ment of permanent teeth and centreline disturbance.Early loss of a primary incisor has little effect uponthe permanent dentition although it does detractfrom appearance. Early loss of primary canines or molars is moreserious since space loss may follow. In each quadrantthe primary canine and molars together are larger thanthe succeeding permanent canine and premolars, thedifference in tooth sizes between the two dentitionsbeing the Leeway space 10. This can be assessed with reasonable trueness by the size difference between first and second primary molars, since the primary first molar is equal in size to the premolarthat will replace it, while the primary second molar ismuch larger than the second premolar. For this reasonthe Leeway space is also known as the E space.Extraction of a primary canine or molar maycause mesial drift of teeth behind the space anddistal drift of anterior teeth, with resultant displacement of permanent teeth and centreline disturbance.Early loss of a primary incisor has little effect uponthe permanent dentition although it does detractfrom appearance.Early loss of primary canines or molars is moreserious since space loss may follow. In each quadrantthe primary canine and molars together are larger thanthe succeeding permanent canine and premolars, thedifference in tooth sizes between the two dentitionsbeing the Leeway space 10. This can be assessedwith reasonable accuracy by the size differencebetween first and second primary molars, since theprimary f irst molar is equal in size to the premolarthat will replace it, while the primary second molar is much larger than the second premolar. For this reasonthe Leeway space is also known as the E space.Extraction of a primary canine or molar maycause mesial drift of teeth behind the space anddistal drift of anterior teeth, with resultant displacement of permanent teeth and centreline disturbance.Impact of early loss of primary molarsPrimary second molar is most often devoted to get caries and results in early loss. Early loss of primary second molars can lead to decrease in arch length prominently in maxilla than in mandible (Ngan et al., 1999). The loss of second primary molar lead to mesial migration of adjacent first permanent molar, loss of space for second premolar eruption and early eruption of second permanent molar. The decrease in arch length is more severe when primary second molar loss occurs prior to eruption of first permanent molar as second primary molar serve as a abs orb for erupting first permanent molar (Ngan et al., 1999). However no substantial change in midline coincidence (Rock and British Society of Paediatric, 2002). Henceforth, it is generally agreed that decrement in space after early loss of primary second molar is more significant than primary first molars and require space maintenance (Ngan et al., 1999).A long term study conducted in Canada to investigate the effects of early loss of primary molars in 107 children over six years of age, 66% of these children had early loss of primary molars majorly because of caries. These children were followed for approximately six years with yearly assessment for space loss. This study reported that loss of space was more when second molar was lost early and its effect is more in maxilla than in mandible, and had detrimental effect on molar relationship. When first and second molars are lost, the arch length was significantly effected in maxilla than mandible. The space loss was mainly due to t he drifting of first permanent molar while canine distal migration was significant until 9 years in mandible and 8-11 years in maxilla. Relatively more space was lost in first year following the extraction with rate of space loss age related in maxilla but not in mandible (Northway et al., 1984).Macena et al., 2011, conducted a study to evaluate the space changes after premature loss of deciduous molars among 55 Brazilian children of age between 6 and 9 years and followed for 10 months. This study reported that early loss of second primary molar lead to significant changes in the space left in both arches. The major decrease in space occurred in the first 3 months after the extraction of the deciduous molars. The decrease in space after second primary molar occurred majorly because of mesial movement of first permanent molar and which may lead to impaction of permanent second premolar or future crowding. They suggested that a space maintainer is needed in such cases especially when it occurs in children with malocclusion and crowding (Macena et al., 2011).Recently a study conducted to determine the space loss after early loss of second primary molar before eruption of permanent molar and after eruption of permanent molar in 87 children and followed for 48 months. They reported that significant space loss occurred in the first six month (P