The permanent maxillary first molar of a 8 yr old child is to be extracted because of caries. The case can be maintained to prevent malocclusion is by
**Core Concept**
The permanent maxillary first molar is a key tooth in maintaining the occlusal relationship and preventing malocclusion. The extraction of this tooth can lead to mesial drift of the adjacent teeth, resulting in an unfavorable occlusal relationship.
**Why the Correct Answer is Right**
To prevent malocclusion, the extraction of the permanent maxillary first molar should be accompanied by a canine substitution procedure. This involves extracting the second molar and placing a canine tooth in the space created. This procedure prevents the mesial drift of the adjacent teeth and maintains the occlusal relationship. The canine tooth is substituted in the space to maintain the proper alignment and prevent the adjacent teeth from drifting into the extracted space.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because simple extraction of the permanent maxillary first molar without any substitution procedure can lead to malocclusion.
* **Option B:** This option is incorrect because extracting the second molar alone will not prevent malocclusion, as the adjacent teeth will still drift into the extracted space.
* **Option D:** This option is incorrect because extracting the lateral incisor will lead to a significant change in the occlusal relationship and can cause malocclusion.
**Clinical Pearl / High-Yield Fact**
To prevent malocclusion, it is essential to consider the extraction and substitution of teeth in a way that maintains the proper occlusal relationship. This can be achieved by substituting a canine tooth in the space created by extracting the second molar.
**Correct Answer:** C.