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Caries

122 - Identifying Predictors for a Caries Free Permanent Second Molar in Second Molar Substitution cases

Friday, May 22, 2026
2:00 PM - 2:15 PM PST
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    Presenting Author(s)

  • SP

    Shane Park, DMD

    PGY2 Pediatric Resident
    Rutgers School of Dental Medicine, Newark, NJ
    Rutgers School of Dental Medicine
    Warren, New Jersey, United States

    • Program Director(s)

  • MM

    Madhu Mohan, DMD

    Rutgers School of Dental Medicine, Newark, NJ
    Newark, New Jersey, United States



Purpose: To evaluate factors associated with caries-free outcomes on substituting permanent second molars (PSMs) following permanent first molar (PFM) extraction.



Methods: A retrospective chart review was conducted using axiUm records of patients who underwent PFM extraction in a dental school clinic. Patient age at extraction was categorized as early ( < 8 years), ideal (8–10 years), or late (>10 years). PSM developmental stage was assessed using Demirjian criteria. Follow-up frequency was categorized as optimal if the patient returned for two or more consecutive treatment appointments with intervals of three months or less after the extraction. Otherwise, the patient was categorized as poor for follow-up frequency. Preventive and educational interventions, including oral hygiene instruction, dietary counseling, and fluoride application, were recorded if documented between extraction planning and the first post-extraction visit. Treatment success was defined as sealant placement on the substituting PSM and failure included treatment codes indicating any active caries. Statistical analyses included bivariate analyses and binary logistic regression to estimate odds ratios and 95% confidence intervals.



Results: A total of 165 PSMs from 114 patients met inclusion criteria. Optimal follow-up frequency and fluoride application were significantly associated with successful outcomes. Patients with optimal follow-up had increased odds of success compared with those with poor follow-up (OR = 2.3; 95% CI: 1.2–4.5; P = .013). Similarly, fluoride application was associated with increased odds of success (OR = 2.4; 95% CI: 1.1–5.1; P = .028). Patient age at extraction, PSM Demirjian stage, oral hygiene instruction, and dietary counseling were not significantly associated with success.



Conclusions: Optimal post-extraction follow-up frequency and fluoride application were associated with significantly increased odds of caries-free outcomes in substituting PSMs following PFM extraction.

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