{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T09:38:09Z","timestamp":1764063489524,"version":"3.45.0"},"reference-count":27,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,11,23]],"date-time":"2025-11-23T00:00:00Z","timestamp":1763856000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health\u2014Current Research IRCCS"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Molar\u2013incisor hypomineralization (MIH) represents a challenging dental condition, often requiring complex and invasive interventions. In severe cases, extraction of the first permanent molars (FPM) is frequently indicated. However, methods to assess the effectiveness of this approach in promoting spontaneous mesialization of the second permanent molars (SPM) through Orthopantomography (OPT), as well as the factors influencing this process, remain unexplored. Aim: This perspective study aimed to assess the effectiveness of novel radiograph-based methods for assessing spontaneous SPM mesialization after FPM extraction and to identify clinical and developmental factors associated with complete space closure. Methods: OPTs of 19 patients (12 males, 7 females; age range 6.2\u201313.8 years) who underwent extraction of 36 FPM due to severe MIH were analyzed by 2 operators. Pre- and post-extraction OPTs were evaluated using specifically developed geometric measurements of distances and angles to quantify SPM movement. Variables considered included patient age at extraction, dental developmental stage (Demirjian index), observation period, and presence or absence of the third permanent molar (TPM). The reliability of the proposed measurements evaluated through ICC (Intraclass Correlation Coefficient) resulted in values above 0.9, confirming excellent intra- and inter-operator reliability. Results: Complete or quite-complete mesialization (target scores 0\u20131 and \u226433% residual space) occurred in 78.6% of maxillary and 73.7% of mandibular sites. Maxillary SPMs showed more favorable spontaneous movement, exhibiting substantial uprighting (e.g., from \u221232\u00b0 to 2\u00b0) and a higher frequency of complete or near-complete space closure (78.6% vs. 73.7% in the mandible). Developmental stages D\u2013E of SPM were associated with successful outcomes. Conclusions: Early extraction of severely compromised first permanent molars (FPMs) can represent an effective treatment option to promote spontaneous mesialization of SPMs, particularly in the maxilla. The proposed radiograph-based measurement method demonstrated high consistency and reproducibility. Overall, this novel measurement approach may serve as a reliable and valuable tool for future clinical and research applications.<\/jats:p>","DOI":"10.3390\/children12121589","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T09:02:07Z","timestamp":1763974927000},"page":"1589","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Spontaneous Second Molar Migration After MIH-Affected First Molars Extraction: A Radiographic-Based Method Evaluation"],"prefix":"10.3390","volume":"12","author":[{"given":"Santo Andrea","family":"Stabilini","sequence":"first","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Fondazione IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3132-1750","authenticated-orcid":false,"given":"Lucia","family":"Giannini","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Fondazione IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8350-6221","authenticated-orcid":false,"given":"Niccol\u00f2","family":"Cenzato","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Fondazione IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Olivi Mocenigo","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7799-5451","authenticated-orcid":false,"given":"Claudia","family":"Salerno","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 30128 Bern, Switzerland"},{"name":"Graduate School for Health Sciences, University of Bern, Freiburgstrasse 7, 30128 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5930-1698","authenticated-orcid":false,"given":"Cinzia","family":"Maspero","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Fondazione IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2704-0585","authenticated-orcid":false,"given":"Maria Grazia","family":"Cagetti","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/S0140-6736(19)31146-8","article-title":"Oral Diseases: A Global Public Health Challenge","volume":"394","author":"Peres","year":"2019","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1159\/000538885","article-title":"Molar Incisor Hypomineralisation as a Dental Caries Risk Factor\u2014Is It True?","volume":"32","author":"Garot","year":"2024","journal-title":"Monogr. Oral. Sci."},{"key":"ref_3","first-page":"661","article-title":"The Global Burden of Oral Diseases and Risks to Oral Health","volume":"83","author":"Petersen","year":"2005","journal-title":"Bull. World Health Organ."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s40368-021-00635-0","article-title":"An Update of Treatment Modalities in Children and Adolescents with Teeth Affected by Molar Incisor Hypomineralisation (MIH): A Systematic Review","volume":"23","author":"Somani","year":"2022","journal-title":"Eur. Arch. Paediatr. Dent."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.jdent.2016.09.012","article-title":"Managing Molar-Incisor Hypomineralization: A Systematic Review","volume":"55","author":"Elhennawy","year":"2016","journal-title":"J. Dent."},{"doi-asserted-by":"crossref","unstructured":"Alzahrani, A.Y., Alamoudi, N.M.H., and El Meligy, O.A.E.S. (2023). Contemporary Understanding of the Etiology and Management of Molar Incisor Hypomineralization: A Literature Review. Dent. J., 11.","key":"ref_6","DOI":"10.3390\/dj11070157"},{"doi-asserted-by":"crossref","unstructured":"Inchingolo, A.M., Inchingolo, A.D., Viapiano, F., Ciocia, A.M., Ferrara, I., Netti, A., Dipalma, G., Palermo, A., and Inchingolo, F. (2023). Treatment Approaches to Molar Incisor Hypomineralization: A Systematic Review. J. Clin. Med., 12.","key":"ref_7","DOI":"10.3390\/jcm12227194"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1111\/ipd.12323","article-title":"The Prevalence of Molar Incisor Hypomineralization: Evidence from 70 Studies","volume":"28","author":"Zhao","year":"2018","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.jdent.2017.12.002","article-title":"Global Burden of Molar Incisor Hypomineralization","volume":"68","author":"Schwendicke","year":"2018","journal-title":"J. Dent."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1016\/j.identj.2024.04.013","article-title":"Is Italian Dentists\u2019 Knowledge of Enamel Development Defects Adequate? A Nationwide Survey","volume":"74","author":"Salerno","year":"2024","journal-title":"Int. Dent. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1038\/sj.bdj.2014.1053","article-title":"National Clinical Guidelines for the Extraction of First Permanent Molars in Children","volume":"217","author":"Cobourne","year":"2014","journal-title":"Br. Dent. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s40368-021-00647-w","article-title":"Extraction of First Permanent Molars Severely Affected by Molar Incisor Hypomineralisation: A Retrospective Audit","volume":"23","author":"Brusevold","year":"2022","journal-title":"Eur. Arch. Paediatr. Dent."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s40368-013-0042-7","article-title":"The Evaluation of Spontaneous Space Closure after the Extraction of First Permanent Molars","volume":"14","author":"Teo","year":"2013","journal-title":"Eur. Arch. Paediatr. Dent."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1111\/j.1365-263X.2007.00849.x","article-title":"Evaluation of Spontaneous Space Closure and Development of Permanent Dentition after Extraction of Hypomineralized Permanent First Molars","volume":"17","year":"2007","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1093\/ejo\/24.1.43","article-title":"Accuracy of Linear and Angular Measurements on Panoramic Radiographs Taken at Various Positions in Vitro","volume":"24","author":"Stramotas","year":"2002","journal-title":"Eur. J. Orthod."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"cjaf055","DOI":"10.1093\/ejo\/cjaf055","article-title":"GuREx-MIH: Radiographic Assessment of Eruption Patterns of Second Permanent Molars and Premolars in 11-Year-Olds after Early Extraction of the First Permanent Molar\u2014A Split-Mouth Trial","volume":"47","author":"Stervik","year":"2025","journal-title":"Eur. J. Orthod."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.pio.2011.04.001","article-title":"Spontaneous Eruption of Impacted Second Molars","volume":"12","author":"Farronato","year":"2011","journal-title":"Prog. Orthod."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"571","DOI":"10.2319\/080406-318.1","article-title":"Orthodontic and Periodontal Outcomes of Treated Impacted Maxillary Canines","volume":"77","author":"Crescini","year":"2007","journal-title":"Angle Orthod."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/0889-5406(87)90005-9","article-title":"Radiographic Examination of Ectopically Erupting Maxillary Canines","volume":"91","author":"Ericson","year":"1987","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_20","first-page":"211","article-title":"A New System of Dental Age Assessment","volume":"45","author":"Demirjian","year":"1973","journal-title":"Hum. Biol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"180","DOI":"10.2319\/061923-423.1","article-title":"Spontaneous Space Closure in Patients Treated with Early Extraction of the First Permanent Molar: A Retrospective Cohort Study Using Radiographs","volume":"94","author":"Aldahool","year":"2024","journal-title":"Angle Orthod."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/j.ajodo.2016.09.018","article-title":"Radiographic Prognostic Factors Determining Spontaneous Space Closure after Loss of the Permanent First Molar","volume":"151","author":"Patel","year":"2017","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_23","first-page":"123","article-title":"Radiographic Evaluation of Permanent Second Molar Substitution After Extraction of Permanent First Molar: Identifying Predictors for Spontaneous Space Closure","volume":"44","author":"Nordeen","year":"2022","journal-title":"Pediatr. Dent."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.4103\/njcp.njcp_606_20","article-title":"Spontaneous Space Closure Following the Extraction of the First Permanent Mandibular Molar","volume":"24","author":"Ciftci","year":"2021","journal-title":"Niger. J. Clin. Pract."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1093\/ejo\/cjv029","article-title":"Lower First Permanent Molars: Developing Better Predictors of Spontaneous Space Closure","volume":"38","author":"Teo","year":"2016","journal-title":"Eur. J. Orthod."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"cjae054","DOI":"10.1093\/ejo\/cjae054","article-title":"Spontaneous Space Closure after Extraction of Permanent First Molars in Children and Adolescents: A Systematic Review and Meta-Analysis","volume":"46","author":"Hamza","year":"2024","journal-title":"Eur. J. Orthod."},{"key":"ref_27","first-page":"72","article-title":"Premature Loss of Primary Molars in Children: Space Recovery through Molar Distalisation. A Literature Review","volume":"25","author":"Cenzato","year":"2024","journal-title":"Eur. J. Paediatr. Dent."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/12\/1589\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T09:33:43Z","timestamp":1764063223000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/12\/1589"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,23]]},"references-count":27,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["children12121589"],"URL":"https:\/\/doi.org\/10.3390\/children12121589","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2025,11,23]]}}}