The aim of this study was to systematically review the literature to determine the sequelae of early extraction of compromised first permanent molars (FPMs) with regard to the skeletal and dental development of 5- to 15-year-old children. Meta-analysis was conducted when applicable. Our research protocol included a search strategy, inclusion/exclusion criteria, and a data extraction plan. The search engines used were PubMed, Scopus, and Science Direct. Study selection was performed independently by three reviewers. Articles published from 1960 to 2017 were reviewed based on inclusion and exclusion criteria. Meta-analysis was performed to compare space closure between upper and lower arches. Eleven studies fulfilled the inclusion criteria. The consequences were decrease in post extraction space, accelerated development and eruption of second permanents molars (SPMs) and third molars, a decrease in caries and/or fillings on the proximal surfaces of adjacent teeth, lingual tipping and retrusion of incisors, and counter clockwise rotation of the occlusal plane. There were several consequences of early extraction of FPMs, which were related to skeletal and dental development. Our systematic review suggests that comprehensive evaluation of the compromised FPMs should be performed before planning an extraction. The ideal time for FPM extraction is when the SPM is at the early bifurcation stage in order to achieve complete closure of the extraction space by the SPM. Benefits should be weighed over the risks to decrease the risk of unfavorable outcomes as much as possible. However, due to the limited evidence on the outcomes and variables that influence them, high-quality prospective studies are needed.

This review discusses the techniques and uses of atraumatic restorative treatment (ART) and interim therapeutic restoration (ITR) and states the differences between these two approaches. ART and ITR are similar approaches and are performed using the same material, but they differ in the purpose of their use. ART is used in cases when there are obstacles to reaching dental care units and has been proven to have high success rates in primary and permanent dentitions. ITR is used as a temporary restoration that will be replaced with a more definitive one. ITR is used in cases when the ideal dental treatment cannot be performed. Conventional glass polyalkenoate (ionomer) restorative cement (GIC) is the material of choice that has been used for ART and ITR. This is because of its fluoride release properties, including its ability to bond to enamel and dentine, its pulpal biocompatibility, and its ease of manipulation. High-viscosity glass ionomer performed better than low and medium-viscosity glass ionomer in ART. Combining GIC with conditioner, as well as the use of a chemo-mechanical approach, improved the success rate of ART. Both ATR and ITR are acceptable strategies, with success rates comparable to the traditional treatment methods.