What the study found
The study found that radiographic signs associated with favorable spontaneous eruption of the second permanent molar were present in only a limited share of children when first permanent molar extraction was being considered. The authors report that this gap reflects a mismatch between ideal developmental timing and the dental disease that often leads to extraction.
Why the authors say this matters
The authors conclude that systematic radiographic evaluation of second permanent molar developmental stage, angulation, and third permanent molar germ presence should be part of individualized treatment planning. The study suggests this is important because extraction is often required after advanced structural disease has already developed.
What the researchers tested
This retrospective study reviewed panoramic radiographs from 500 pediatric patients with extraction-indicated first permanent molars, involving 712 teeth. The researchers recorded demographic features, dentition stage, extraction indications, second permanent molar developmental stage using the Demirjian classification, second permanent molar angulation, and the presence of a third permanent molar germ.
What worked and what didn't
Extensive carious destruction was the most common extraction indication, followed by repeated treatment interventions, severe structural breakdown, and molar-incisor hypomineralization-related defects. Among the radiographic findings, 17.6% of second permanent molars were at Demirjian stage E, 27.4% were at stage F, 55.2% showed mesial angulation, and 74.2% had a third permanent molar germ present. Only 12.8% of cases met all predefined radiographic conditions associated with favorable eruption potential after first permanent molar extraction.
What to keep in mind
The study is retrospective and based on panoramic radiographs from one pediatric sample, so it describes associations rather than testing a treatment effect. The abstract does not describe longer-term clinical follow-up of eruption outcomes for all cases, and it does not report limitations beyond the restricted availability of favorable radiographic conditions.
Key points
- Only 12.8% of cases met all predefined radiographic conditions linked to favorable second permanent molar eruption.
- Extensive carious destruction was the main reason for first permanent molar extraction.
- Most second permanent molars were not at the most favorable developmental stage, and many showed mesial angulation.
- A third permanent molar germ was present in 74.2% of cases.
- The authors recommend systematic radiographic assessment during individualized treatment planning.
Disclosure
- Research title:
- Favorable second molar eruption signs were uncommon at first molar extraction
- Authors:
- Kaan Marım, Elif Kuru, Hayal Boyacıoğlu, Dilşah Çoğulu
- Institutions:
- Ege University, Ege University, Ege University, Usak University
- Publication date:
- 2026-06-29
- OpenAlex record:
- View
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