The effect of premature extraction of primary teeth on the subsequent need for orthodontic treatment

Eur Arch Paediatr Dent. 2016 Dec;17(6):423-434. doi: 10.1007/s40368-016-0247-7. Epub 2016 Nov 3.


Aim: This was primarily to examine the effect of premature extraction of primary teeth (PEPT) on subsequent malocclusion and need for orthodontic treatment in the permanent dentition. The secondary aim was to correlate the effect of PEPT with loss of space in the primary and mixed dentitions.

Methods: A predefined protocol was developed and registered prospectively with PROSPERO database. The electronic databases, searched, were MEDLINE, EMBASE, PubMed, and Cochrane Central Register of Controlled Trials. The study designs considered for inclusion were controlled trials, cohort, and case-control studies. Risk of bias was assessed using a validated quality assessment tool.

Results: 513 studies were identified. Sixteen studies were included in the systematic review, one study reported on malocclusion, and 15 studies reported on space changes. Narrative synthesis was undertaken owing to the heterogeneity of the included studies. No study examined the effect of PEPT on orthodontic need. Most studies reported on space dimensions used a split-mouth design and were at a high risk of bias.

Conclusions: The included literature identified that PEPT led to various features of malocclusion and space loss in the mixed and permanent dentitions. No studies, that met the inclusion criteria, described the effect of PEPT on the subsequent need for orthodontic treatment.

Keywords: Malocclusion; Orthodontic need; Premature extraction; Primary teeth; Space loss; Systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Humans
  • Malocclusion / therapy
  • Orthodontics, Corrective / methods*
  • Tooth Extraction / adverse effects*
  • Tooth, Deciduous*