Effects of Premature Primary Tooth Loss on Midline Deviation and Asymmetric Molar Relationship in the Context of Orthodontic Treatment

Aim: The aim of this retrospective pilot study was to investigate the effects of premature loss of primary teeth on molar relationships and midline discrepancies in young patients and explore its potential implications for dental treatments, including orthodontics. Materials and methods: A total of 550 study models from individuals seeking orthodontic treatment were evaluated, and 175 models met the inclusion criteria of mixed dentition. Each study model was examined for midline discrepancies, asymmetric molar relationships, and the impact of net premature tooth loss on the midline shift. Four investigators analyzed the data, and the error was minimized to less than 5%. Results: The study revealed that premature loss of primary first molars was significantly associated with the midline shift, while premature loss of canines and second molars did not show substantial associations with midline discrepancies. The concordance analysis between observed and expected molar classifications based on premature tooth loss indicated relatively low concordance for all three molar classes, with higher concordance observed in Class II molar relationships. Notably, premature loss of primary second molars showed higher concordance than premature loss of primary first molars. Conclusion: This retrospective pilot study highlights the potential dental complications associated with premature loss of primary teeth. Premature loss of primary first molars was found to be significantly linked to the midline shift, while the premature loss of canines and second molars did not demonstrate significant midline discrepancies. The concordance analysis revealed limited agreement between observed and expected molar classifications based on premature tooth loss, with higher concordance observed in Class II molar relationships and primary second molars. Further research with larger prospective cohorts and digital model analyses is warranted to gain a better understanding of the impact of premature tooth loss on dental treatment outcomes. The findings underscore the importance of early detection and appropriate intervention to mitigate potential adverse effects on dental arch development and malocclusion.