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Objective <p>To quantify space loss following premature extraction of primary first molars (Ds) over a follow-up period of at least six months and evaluate its clinical implications.</p> Materials and methods <p>A systematic search of PubMed, Cochrane Library, LILACS, Web of Science, and Embase was conducted. Only longitudinal split-mouth cohort studies were included. The primary outcome was the amount of space loss in the extraction region, measured against the contralateral control side.</p> Results <p>7 studies were included, comprising 141 children for maxillary analysis and 171 children for mandibular analysis. Meta-analysis for space loss revealed a mean difference (MD) of -0.52&#xa0;mm (95% CI: -0.79 to -0.26; <i>p</i> &lt; 0.001) in the maxilla after 9–12 months, and − 1.78&#xa0;mm (95% CI: -2.09 to -1.47; <i>p</i> &lt; 0.001) in the mandible after 8–9 months.</p> Conclusions <p>Premature loss of Ds in children aged 6–9 years results in space loss of -0.52&#xa0;mm in the maxilla and − 1.78&#xa0;mm in the mandible. Space maintainers are indicated following mandibular extractions, while maxillary cases may not require routine intervention.</p>

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Extraction of first primary molars and significance of space loss: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月13日

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  • Ahmed Kamal El-Motayam,
  • Mostafa A. Hassan,
  • Mais Medhat Sadek,
  • Rim Fathalla,
  • Nour Wahba,
  • Reem Mahmoud,
  • Shereen Hassan Elshamy

摘要

Objective

To quantify space loss following premature extraction of primary first molars (Ds) over a follow-up period of at least six months and evaluate its clinical implications.

Materials and methods

A systematic search of PubMed, Cochrane Library, LILACS, Web of Science, and Embase was conducted. Only longitudinal split-mouth cohort studies were included. The primary outcome was the amount of space loss in the extraction region, measured against the contralateral control side.

Results

7 studies were included, comprising 141 children for maxillary analysis and 171 children for mandibular analysis. Meta-analysis for space loss revealed a mean difference (MD) of -0.52 mm (95% CI: -0.79 to -0.26; p < 0.001) in the maxilla after 9–12 months, and − 1.78 mm (95% CI: -2.09 to -1.47; p < 0.001) in the mandible after 8–9 months.

Conclusions

Premature loss of Ds in children aged 6–9 years results in space loss of -0.52 mm in the maxilla and − 1.78 mm in the mandible. Space maintainers are indicated following mandibular extractions, while maxillary cases may not require routine intervention.