Abstract
Aims and Objectives: The aim of this study was to consider the available evidence regarding early extraction of permanent first molars (PFMs) in different mixed dentition stages that affect the integrity of occlusion and the implications for treatment planning. Materials and Methods: Electronic database, including PubMed and Science Direct, searches were conducted for available evidence. Key terms used in the search were "extraction," " first permanent molar," and "mixed dentition." Results: The initial search identified 56 studies to be related to the review. Although a significant number of published articles had dealt with early extraction of PFM, only three studies had fulfilled the final selection criteria to be considered for this systematic review. Conclusion: Future active appliance treatment is important after extraction of PFMs with poor prognosis. If such therapy is not needed, consideration should be given to extraction at the ideal developmental age to achieve spontaneous space closure. Each case should be assessed for the need of balancing or compensating extractions to preserve the dental midline and prevent overeruption.