Influence of first Premolar Extraction on Second and Third Molar Angulation - A Clinical Study


  • CSMSS Dental College & Hospital, Department of Orthodontics, Aurangabad, Maharashtra, India


Background: In modern populations, the impaction rate is higher for third molars than for any other tooth. Due to the speculation of third molar role on late incisor crowding, many orthodontists prescribe removal of third molars before, during or just after orthodontic treatment. Objectives: The aim of this study was to compare whether orthodontic extraction of first premolar lead to any angular changes in second and third molars. Material and method: Orthopantograms of 20 patients undergoing orthodontic treatment were collected pre and post treatment. The patients were divided into two groups - nonextraction and extraction group. Each group consisted of 10 patients. The angles were measured between the long axis of 2nd molar and 3rd molar with horizontal plane. Changes in 2nd and 3rd molar angulation from pre-treatment to post treatment for two groups were compared by Mann- Whitney utest. Results: Statistical analysis revealed that maxillary and mandibular 2nd and 3rd molar showed an improvement in angulation but it was statistically non-significant. Conclusion: The findings of the present investigation suggest that premolar extraction therapy has a favourable effect on maxillary second&third molar angulation, while no changes in mandibular second&third molar angulation during treatment were found in patients treated with and without premolar extractions.


Extraction, 2nd Molar, 3rd Molar Angulation, Orthodontic Treatment, 1st Premolar.

Subject Discipline


Full Text:


Staggers JA, Germane N, Fortson WM. A comparison of the effects of first premolar extractions on third molar angulation. Angle Orthod 1992;2:135– 138.

Suruchi Jain, Ashima Valithan. Influence of first premolar extraction on mandibular third molar angulation.

Angle orthod 2009;79:1143-1148.

Kim TW, Artun J, Behbehani F, Artese F. Prevalence of third molar impaction in orthodontic patients treated nonextraction and with extraction of 4 premolars. Am J Orthod Dentofacial Orthop 2003;123:138–145.

Dachi SF, Howell FV. A survey of 3874 routine full-mouth radiographs II. A study of impacted teeth. Oral Surg Oral Med Oral Pathol 1961;14:1165–1169.

Bishara SE, Andreasen G. Third molars: a review. Am J Orthod 1983;83:131–137.

Grover PS, Lorton L. The incidence of unerupted permanent teeth and related clinical cases. Oral Surg Oral Med Oral Pathol 1985;59:420–425.

Bjork A, Jensen E, Palling M. Mandibular growth and third molar impaction. Acta Odontol Scand 1956;14:231–271.

Bjork A. Variations in the growth pattern of the human mandible: longitudinal radiographic study by the implant method. J Dent Res 1963;42:400–411.

Alling CC, Alling RD. Indications for Management of Impacted Teeth. Impacted Teeth. Philadelphia: WB Saunders Co; 1993.p.46–49.

Silling G. Development and eruption of the mandibular third molar and its response to orthodontic therapy. Angle Orthod 1973;43:271–278.

Sicher H. Oral anatomy. St Louis: CV Mosby; 1965.p.129–131.

Peterson LJ. Principles of management of impacted teeth. In Peterson LJ, Ellis E, Hupp JR, Tucker MR editors. Contemporary oral and maxillofacial surgery. St Louis: Mosby; 1998.p.215– 248.

Fosberg CM. Tooth size, spacing and crowding in relation to eruption or impaction of third molars. Am J Orthod Dentofacial Orthop 1988;94:57-62.

Al-Balkhi KM. The effect of different lower third molar conditions on the recrowding of the lower anterior teeth in the absence of tight interproximal contacts one year post orthodontic treatment: a pilot study. J

Contemporary dental practice 2004;5(3):66-73.

Faubion BH. Effect of extraction of premolars on eruption of mandibular third molars. J Am Dent Assoc 1968;76:316-320.

Richardson ME. The relative effects of the extraction of various teeth on the development of mandibular third molars. Trans Europe Orhtod Soc 1976:79-85.

Saysel MY, Meral GD, Kocadereli I, Tasar F. the effect of first premolar extraction on third molar angulations. Angle Orthod 2005;75:604-607.

Jon Artun, Lukman Thalib, Robert Little. Third molar Angulation during and after treatment of adolescent orthodontic patients. European Journal of Orthodontics 2005;27:590–596.

Janson G, Putrick LM, Henriques JFC, De Freitas MR, Henriques RP. Maxillary third molar position in class II malocclusion: the effect of treatment with and without maxillary premolar extractions. Europ J Orthod


Salehi P, Danaie SM. Lower third molar eruption following orthodontic treatment. La Revue de Sante La Mediterranee orientale 2008; 14(6):1452-1458.

Richardson M. Changes in lower third molar position in the young adult. Am J Orthod Dentofacial Orthop 1992; 102:320-327.

Murph TR. Reduction of the dental arch by approximal attrition. Br Dent J 1964;116:483-488.

Forsberg CM, Vingren B, Wesslen U. Mandibular third molar eruption in relation to available space as assessed on lateral cephalograms. Swed Dent J 1989;13:23–31.

Richardson ME. The effect of mandibular first premolar extraction on third molar space. Angle Orthod 1989;59:291–294.

Yigit M, Gokce D, Kocadereli I, Tasar F. The effects of first premolar extractions on third molar angulations. Angle Orthod 2005;75:719–722.

Artun J, Thalib L, Little RM. Third molar angulations during and after treatment of adolescent orthodontic patients. Eur J Orthod 2005;27:590–596.

Behbehani F, Artun J, Thalib L. Prediction of mandibular third molar impaction in adolescent orthodontic patients. Am J Orthod Dentofacial Orthop 2006;130:47–55.

Olive RJ, Basford KE. Transverse dentoskeletal relationships and third molar impaction. Angle Orthod 1981;51:41–47.

Larheim TA, Svanaes DB. Reproducibility of rotational panoramic radiography: mandibular linear dimensions and angles. Am J Orthod Dentofacial Orthop 1986;90:45–51.

Nanda RS. Reappraising ‘‘Wits.’’ Readers’ forum. Am J Orthod Dentofacial Orthop 2004; 125:18A.

Elsey MJ, Rock WP. Influence of orthodontic treatment on development of third molars. Br J Oral Maxillofac Surg 2000;38:350–353.


  • There are currently no refbacks.