Early extraction of the first permanent molar and spontaneous closure of the extraction gap –⁠ indications, risks and implications

Czech version

Authors: E. Řezáčová ^1,2,*; J. Hálek ^1,3
Authors‘ workplace: Korespondující autorka ^*; Stomatologická klinika, Lékařská fakulta v Plzni, Univerzita Karlova ¹; Stomatologická klinika, Fakultní nemocnice Plzeň ²; Ortodontická ordinace Rideto, s. r. o., privátní praxe, Strakonice ³
Published in: Česká stomatologie / Praktické zubní lékařství, ročník 125, 2025, 3, s. 63-69
Category: Review Article

Overview

Introduction and aim: Severe caries, malformation or other damage to the first permanent molar can be treated by extraction in clinical practice. This consideration is based on the assumption that extraction of the first permanent molar will result in spontaneous mesial displacement of the second permanent molar and its repositioning in place of the first molar, thereby closing the gap. However, daily clinical practice shows that this procedure is not so clear-cut and yields different results. The aim of this paper is to summarize the literature findings related to the extraction of the first permanent molar and the subsequent spontaneous closure of the extraction gap, as well as to review the recommended clinical procedures.

Methods: PubMed, ResearchGate and Google Scholar databases were used to indentify relevant studies. Searches were conducted in English and Czech using the key words "first permanent molar", "extraction", "spontaneous" and "gap closure". Studies published between 2000 and 2024 were included in the review.

Results: Seventeen articles met the inclusion criteria. Additional articles that did not fully meet the criteria were also included to provide a more comprehensive overview of the topic. Conclusion: Extraction of the first permanent molar is a procedure with significant consequences for the development of an individual's dentition. Appropriate timing and careful indication are essential, as improper management may result in complicated or even irreversible occlusal defects. Therefore, it is always advisable to consult an orthodontist before any early extraction of a permanent tooth.

Keywords:

first permanent molar, extraction, spontaneous, gap closure

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