Maxillary first-molar extraction spaces managed with aligners: A report of 3 patients

The first molars are highly susceptible to early dental caries, and progression and/or recurrent decay can sometimes lead to extraction of these teeth. In such situations, the decision to close the extraction space or to manage it for prosthetic replacement requires careful consideration of various factors, including extraction site parameters (reason for extraction, recency, ridge height and width, proximity of sinus, etc), amount of crowding, size of the second and third molars, mesiodistal crown inclinations of the premolars and molars, potential for root resorption, and the patient's age. We present three adult cases treated with clear aligners: one with retention of the maxillary first-molar space and two with space closure. Of the two patients who underwent space closure, one had severe crowding of the maxillary arch and one had mild crowding. In this report, we discuss management approaches and factors contributing to the successful treatment of maxillary first molar spaces.