Abstract
Introduction: The mandibular molar is considered the most difficult tooth to move. In certain clinical situations, it would seem useful to move it backward. Is that feasible? When would it be indicated? Is it successful, and if so how? Material and methods: We first review some fundamental principles and present an update of the literature on mandibular molar distalization, then analyze a retrospective series of 11 patients for whom mandibular molar distalization was planned. The movement achieved was studied on dental cephalometric superimposition with Delaire analysis. Results: the desired pure distal translation was achieved in 2 of the 11 cases; distalization was accompanied by coronary tip-back in 3 cases; in 4 cases, only coronary tipback was achieved, and apical tip-forward in 2 cases. Conclusion: Further studies are needed to determine optimally effective and reproducible distalization modalities for the mandibular molar.
Highlights
The mandibular molar is considered the most difficult tooth to move
7 cases managed by Dr JeanPaul Forestier (JPF), in private practice in Paris;
2 cases managed by Dr Benoıt Thebault (BT), in private practice in Redon (France);
Summary
The mandibular molar is considered the most difficult tooth to move. Conclusion: Further studies are needed to determine optimally effective and reproducible distalization modalities for the mandibular molar. Orthodontic displacement of the mandibular molar, other than extrusion, is reputed to be extremely difficult, due to the large root area and root anatomy[3]. Extreme measures may be taken to avoid irreversible or risk-laden procedures such as extraction or orthognathic surgery. Organizing the space within the dental arcade involves two essential factors: tooth size and arcade perimeter. The latter is determined by the anterior, lateral and posterior edges, and the space occupied by the arcade depends on 3D compensatory curves.
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