Radiographic Assessment of Permanent First Molars Among patients in Tripoli: A Retrospective cross-sectional Study

Abstract

The first permanent mandibular molar (FPM) is the first tooth to emerge. It is the most effective oral masticatory unit because of its large occlusal surface and function in proper occlusion. This study aimed to describe the prevalence of PFM loss and status among adult patients in Tripoli, Libya. Materials and Methods: A retrospective study was conducted using patient panoramic radiographs from three private dentistry clinics in Tripoli, Libya. Panoramic images (OPG) of 1244 patients aged 13 years and older were evaluated to determine the status of PFM. For categorical variables, descriptive statistics of frequency distribution and percentages were generated, and the difference between the variables was assessed using the chi-square test. A p-value of < 0.05 was considered statistically significant. The results indicated that females had a much higher rate of missing FPMs than males (20.7% vs. 17.9%, respectively). Missing FPMs were more common in the mandibular arch than in the maxillary arch (21.3% vs. 17.6%), with a statistically significant difference. Endodontically treated FPMs accounted for 8.2% of the evaluated teeth, whereas 91.8% had not undergone endodontic treatment. Males had a slightly greater rate of endodontically treated FPMs (8.5%) than females (8.0%). Females had more restored and missing teeth than males, whereas males had higher proportions of remaining roots, crowns, and implants. A statistically significant association was observed between FPM status and dental arch. The mandibular arch showed higher proportions of carious, restored, and missing FPMs, whereas the maxillary arch showed a higher proportion of intact and crowned FPMs. Conclusion: Although intact first permanent molars represented the most common finding, a considerable proportion of FPMs had been affected by caries, were missing, fixed, or had undergone endodontic therapy. Missing FPMs were more common in females and in the mandibular arch, and endodontic therapy was mostly associated with age. These findings highlight the importance of early preventive and restorative interventions to preserve first permanent molars and reduce the burden of tooth loss and extensive dental treatment.