title: Therapeutic decisions in the presence of decayed permanent first molars in young subjects: a descriptive inquiry.
abstract: The aim of this exhaustive descriptive epidemiological study was to determine the clinical approach to be adopted by practitioners specializing exclusively in pediatric odontology and by orthodontists when confronted with decayed molars in children and adolescents.
  
  
  METHODS
  A questionnaire was sent out to all corresponding practitioners (n=2076). Six questions related to treatment decisions taken when faced with decayed permanent first molars (unfavorable short or middle-term prognosis) in patients needing, or not, orthodontic care. The Chi(2) test was used to compare responses.
  
  
  RESULTS
  Thirty-eight per cent of pedodontists (n=38) and 12.5% (n=246) of orthodontists answered the questionnaire. Faced with a permanent first molar with an unfavorable middle-term prognosis, 75.7% needed criteria to help them reach their treatment decision. In decreasing order of importance, these criteria were: presence of the third molar, patient motivation, inter-arch relationship, patient's oral hygiene, facial type, anterior jaw-teeth discrepancy and the number of molars to be extracted. Faced with a permanent first molar requiring extraction and when orthodontic treatment was not required, 31.7% of practitioners decided to close the maxillary space immediately as opposed to 13.4% who closed the space at the mandible. In the presence of a single decayed first molar, 68.7% of practitioners did not extract the antagonist or contralateral first molars.
  
  
  CONCLUSIONS
  These treatment decisions were not always unanimous and call for a combined approach between dental surgeon and orthodontist.
authors.affiliation: Département orthopédie dentofaciale, UFR odontologie, université de Nice Sophia-Antipolis, 24, avenue Diables-Bleus, 06357 Nice, France.
authors.forename: Millewa
authors.initials: M
authors.lastname: Sayagh
authors.forename: Armelle
authors.initials: A
authors.lastname: Maniere-Ezvan
authors.forename: Cindy
authors.initials: C
authors.lastname: Vernet
authors.forename: Michèle
authors.initials: M
authors.lastname: Muller-Bolla
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D003442:Crowns; D003657:Decision Making; D019140:Dental Care for Children / Q000379:methods / Q000706:statistics & numerical data; D003731:Dental Caries / Q000628:therapy*; D015921:Dental Implants; D019229:Dentition, Permanent; D003830:Denture, Partial, Fixed; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D008963:Molar / Q000473:pathology*; D008964:Molar, Third / Q000637:transplantation; D019516:Orthodontic Space Closure; D009970:Orthodontics / Q000706:statistics & numerical data; D009971:Orthodontics, Corrective; D057240:Patient Preference; D010377:Pediatric Dentistry / Q000706:statistics & numerical data; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data*; D012390:Root Canal Therapy; D011795:Surveys and Questionnaires; D014081:Tooth Extraction / Q000706:statistics & numerical data*
chemical_list: D015921:Dental Implants