The impact of the loss of first permanent molars on the duration of treatment in patients treated with orthodontic space closure and without skeletal anchorage

Background This study aims to evaluate the impact of the loss of permanent molars on the duration of orthodontic treatment for space closure and without skeletal anchorage. Methods Records at the beginning (T0) and the end (T1) of orthodontic treatment were selected retrospectively. Patients were divided into two groups: loss of molar (n = 19) and control, without loss (n = 24). The impact of loss on treatment time was assessed using multiple linear regression adjusted for the number of absences, bonding failures, age, sex, PAR index at T0 and T1 at p<0.05. Treatment time was also evaluated by the number of losses and which arches were involved (upper, lower). The systematic and random errors for the PAR index were verified using the intraclass correlation coefficient (ICC) and the Dahlberg formula, respectively. Results A small random error (1.51) and excellent replicability (ICC = 99.6) were observed. Overall average treatment time was 22.5 months (+/- 7.95) for the group without loss and 44.7 months (+/- 17.3) with a loss. Treatment time was longer in cases where there was a higher number of missing molars and when both arches were involved. In addition to the loss (beta = 4.25, p < 0.001), the number of missed appointments (beta = 2.88, p < 0.001) had a significant effect and increased treatment time. Bonding failures, gender, age, and PAR index at T0 and T1 were not significantly associated with treatment time in the multivariate model (p > 0.05). Conclusion Loss of the first permanent molar has a negative impact on orthodontic treatment time in cases of space closure. The treatment time is longer when there are more tooth losses and arches involved. Treatment time also increases with greater numbers of missed clinical appointments.

Automated summary

This study evaluated the impact of permanent molar loss on the duration of orthodontic treatment and found that the loss of molars leads to longer treatment time, especially when there are more missing teeth or both arches are involved. Additionally, the number of missed clinical appointments also increases treatment time.