Personally, I don't think you need dedicated trackball buttons, especially if you've placed your TB in the usual, middle spot, because the buttons for both joysticks are right there. Oddly though, I find myself usually preferring to use P1, button 6 for my fire button in Centipede. Go figure.
As far as having exclusive mouse buttons, I think they really are a huge help. If you're concerned about cluttering up the panel, you can always do what I did and mount them on the sides of the panel, right where the buttons would be on a pinball machine. I wanted some there anyhow, so I could play PinMAME games, and they're easily mapped for most commercial PC pinball games as well.