Tooth Replacement Research Articles

Nonlinear Finite Element Analysis of Bone–Implant Contact in Three Short Dental Implant Models with Varying Osseointegration Percentages

Objectives: Dental implants have become a cornerstone of restorative dentistry, providing a long-lasting method for tooth replacement. The degree of osseointegration has a significant effect on biomechanical stability at the bone–implant contact (BIC), determining the continued efficacy of these implants. However, the exact consequences of changing osseointegration levels on different implant designs, especially in bones with variable densities, are not well known. Methods: This study used 3D finite element analysis (FEA) to look at the biomechanical performance of three short dental implants: BioMet 3iT3, Straumann® Standard Plus Short-Regular Neck (SPS-RN), and Straumann® Standard Plus Short-Wide Neck (SPS-WN). This paper tested the implants at four stages of osseointegration: 25%, 50%, 75%, and 100% in both high-density (bone type III) and low-density (bone type IV) cancellous bone. It also created and examined realistic CAD models under static occlusal loading conditions to assess stress distribution and major strains at the bone–implant contact. Results: The study discovered that as osseointegration increases, von Mises stress and principal strains go down significantly for all implant types. The SPS-WN implant had the lowest strain values, especially for bone with low density. These reductions demonstrate increased mechanical stability as the bone–implant interface becomes more capable of dispersing mechanical stresses, minimizing the potential for localized deformation and bone resorption. Conclusions: The results highlight the importance of achieving optimum osseointegration to reduce mechanical stress and increase the lifespan of dental implants. The SPS-WN type implant performed better in biomechanical tests than the others, especially when bone conditions were not ideal. This makes it a great choice for clinical applications that need long-term implant success.

A small venomous reptile from the Late Triassic (Norian) of the southwestern United States.

Reptile feeding strategies encompass a wide variety of diets and accompanying diversity in methods for subduing prey. One such strategy, the use of venom for prey capture, is found in living reptile clades like helodermatid (beaded) lizards and some groups of snakes, and venom secreting glands are also present in some monitor lizards and iguanians. The fossil record of some of these groups shows strong evidence for venom use, and this feeding strategy also has been hypothesized for a variety of extinct reptiles (e.g., archosauromorphs, anguimorphs, and a sphenodontian). However, evidence of systems for venom delivery in extinct groups and its evolutionary origins has been scarce, especially when based on more than isolated teeth. Here, we describe a potentially venomous new reptile, Microzemiotes sonselaensis gen. et sp. nov., from a partial left dentary recovered from the Sonsela Member of the Chinle Formation (middle Norian, Upper Triassic) of northeastern Arizona, U.S.A. The three dentary teeth have apices that are distally reclined relative to their bases and the tip of the posteriormost tooth curves mesially. The teeth show subthecodont implantation and are interspaced by empty sockets that terminate above the Meckelian canal, which is dorsoventrally expanded posteriorly. Replacement tooth sockets are positioned distolingually to the active teeth as in varanid-like replacement. We identify this new specimen as a diapsid reptile based on its monocuspid teeth that lack carinae and serrations. A more exclusive phylogenetic position within Diapsida is not well supported and remains uncertain. Several features of this new taxon, such as the presence of an intramandibular septum, are shared with some anguimorph squamates; however, these likely evolved independently. The teeth of the new taxon are distinctively marked by external grooves that occur on the entire length of the crown on the labial and lingual sides, as seen in the teeth of living beaded lizards. If these grooves are functionally similar to those of beaded lizards, which use the grooves to deliver venom, this new taxon represents the oldest known reptile where venom-conducting teeth are preserved within a jaw. The teeth of the new species are anatomically distinct from and ~10x smaller than those of the only other known Late Triassic hypothesized venomous reptile, Uatchitodon, supporting venom use across multiple groups of different body size classes. This new species represents the third Late Triassic reptile species to possibly have used envenomation as a feeding (and/or defensive) strategy, adding to the small number of venomous reptiles known from the Mesozoic Era.

Surgical Endodontic Management Of Maxillary Incisors: A Case Report

In the root canal system, infection of the pulp tissue caused by caries or other pathways is the primary cause of apical periodontitis. The ultimate goal of the endodontic treatment is to create adequate conditions for periradicular tissue healing. Nonsurgical endodontic treatment is a highly predictable treatment option in most cases, but surgery may be indicated for teeth with persistent periradicular pathosis unresponsive to nonsurgical approaches. The aim of this article is to highlight the possibility of the successful outcome of surgical endodontic treatment following failed non-surgical treatment of right maxillary central incisor. With proper case selection and operator skill, periradicular surgery can be considered predictable, cost-effective alternative to tooth extraction and tooth replacement.

Immediate implant placement in damaged extraction sockets: a systematic review and meta-analysis of randomized controlled trials.

The aim of this study was to observe whether immediate implant placement (IIP) into damaged extraction sockets is a successful modality for treating hopeless teeth that require extraction. An electronic search was carried out through four databases (PubMed/MEDLINE, Web of Science, Scopus, and ScienceDirect) to identify randomized controlled trials (2013-2023) to understand whether IIP in damaged sockets is a successful treatment. The focus question was, 'In a patient with a hopeless tooth that needs extraction with the indication for dental implant treatment, is IIP in damaged extraction sockets, compared to undamaged sockets or healed sites, an effective method for the replacement of hopeless teeth and achieving a favorable clinical result?' The risk of bias was appraised and a meta-analysis using random effect was applied. Five studies with 135 patients and 138 implants were included. The implant survival rate was 100% for all studies and period evaluated; the pink esthetic score (PES) scores had no statistically significant result for all articles that evaluated this parameter; the soft tissue changes was reported by two studies: one found no significant differences and the other showed that the test group experienced reduced soft tissue loss at the 1-year evaluation (measured with digital intraoral scanners); other two studies assessed the marginal bone loss, presenting no differences between groups. The meta-analysis showed homogeneity between the studies. There was an equilibrium among the groups in the various studies included, and age tended to be lower in the test group. The buccal bone tissue and pink esthetic score showed favoritism for the test group but without statistical significance. This study suggests that IIP in the presence of buccal bone defects can achieve comparable clinical and radiological outcomes to traditional methods in the short term of the limited studies available. The buccal aspect is not possible to be evaluated through radiographs. Bone regeneration was essential to reach optimal results. It is important to emphasize that IIP requires adherence to rigorous criteria to ensure functionally acceptable results.

Knowledge And Perception About Dental Implant And Its Complications Among GeneralPractitioners And Post Graduates In Coimbatore – A Cross Sectional Survey

Background: It is necessary for dental students and freshly graduated dentists to apply their education and practice to different clinical and preclinical procedures. The implant success rate and durability are high. Therefore, this study was designed to assess the level of knowledge, awareness and perception of dental practitioners and post graduate students regarding dental implant complications in Coimbatore. Materials and Methods: A prevalence study design using a web-based method was conducted among dental practitioners and postgraduate students in Coimbatore. Data were collected from all (n = 212) general dental practitioners and postgraduate students using a pretested standardized self-administered web-based questionnaire that was prepared and circulated using a template provided by Google Forms (Google, Inc., USA). Results: In a survey of 212 general dental practitioners and postgraduate students in Coimbatore, 69.2% considered dental implants a viable option for tooth replacement, though 38% noted financial constraints affecting patient acceptance. While 38.5% were highly aware of the risks associated with implants, 61.5% emphasized the importance of case selection. Common issues included postoperative infections (53.8%) and screw loosening (46.2%). Aesthetically, 30.8% cited loss of the interdental papilla as a concern. Most participants favored flap surgical methods (61.5%) and recommended considering patient conditions when choosing implant prostheses. Notably, 61.5% were aware of regenerative possibilities related to dental implants. Conclusion: A comprehensive evaluation concluded that undergraduate instruction in basic implantology is essential due to the increasing prevalence of implants. Additionally, postdoctoral training programs should be established to enhance practitioners' skills and knowledge, providing them with the confidence needed to treat patients effectively

Current Updates in Implant Dentistry Materials

Background: Permanent tooth loss without replacement results in impaired chewing function, aesthetics, phonetics, and balance of the masticatory organs which can lead to more complex dental and oral health problems. Dental implants are the best treatment alternative today to restore masticatory function, aesthetics, and phonetics more perfectly. The use of implants allows tooth replacement that resembles the patient's previous natural teeth, both in terms of aesthetics and comfort. Until now, many types of materials have been studied and applied as dental implant materials. Objective: This review aims to analyze the latest developments regarding materials used for dental implants. Methods: A literature search was conducted on the PubMed, ScienceDirect, Cochrane, and Scopus databases until December 2023 using predetermined keywords and the results were limited to articles published in 2018-2023 with full-text open-access. Conclusion: The selection of ideal implant material for patients can be adjusted to the patient's needs taking into account the physical, mechanical, and biocompatibility properties of the material.

Bacterial Contamination as an Important Prognostic Factor in Tooth Avulsion and Replantation - Case Series

Tooth Avulsion is a significant traumatic injury in children, replantation and follow up care is the treatment of choice. Maxillary incisors are most affected and sometimes over treated or left untreated. Aim: To understand the role of bacterial contamination for the survival of permanent maxillary incisors in cases of avulsion in children Case Report: This paper presents 3 case reports outlining the treatment stages for the survival of avulsed permanent incisors. Pulp & periodontal damage and its tissue responses are discussed through various clinical factors responsible for good prognosis. Result & Observations: Preserving alveolar bone width, retaining aesthetics and function even for an interim period is a favorable outcome. It helps in the replacement of tooth at a convenient period of late adolescence or young adult stage. Conclusion: Immediate replantation is always recommended for good prognosis of tooth avulsion in children.

Feasibility of Immediate, Early and Delayed Implant Placement for Single Tooth Replacement in the Premaxilla: A Retrospective Cone-Beam Computed Tomography Study of 100 Cases.

To assess the feasibility of immediate (IIP), early (EIP) and delayed implant placement (DIP) for single tooth replacement in the premaxilla on the basis of the complete indication area of each approach in routine practice. Data from 100 patients (59 women, 41 men, all Caucasians) aged between 19 and 81 years old (mean age 51.71) who had been consecutively treated with a single implant in the premaxilla (13-23) in one private periodontal practice were retrospectively collected. Demographic data, diagnostic information and linear measurements were extracted from patient files and CBCTs. The feasibility of IIP, EIP and DIP was assessed for all cases by both authors, based on the following criteria: availability of apical bone, position of the tooth in relation to the morphology of the alveolar process, buccal bone morphology and presence of midfacial recession. The reasons for not being able to perform an approach, and the viable alternatives for each approach were secondary outcomes. DIP was considered to have been preceded by alveolar ridge preservation (ARP). Ninety-two patients could be treated by means of IIP, EIP or DIP. In eight patients none of these approaches were possible as they required bone augmentation prior to implant placement. Fifty-two patients (95% CI: 42%-62%) could by treated with IIP, 58 (95% CI: 48%-67%) with EIP and 88 (95% CI: 80%-93%) with DIP. The feasibility proportions of IIP and EIP were significantly lower than the one of DIP (p < 0.001). All patients who could be treated with IIP could also be treated with EIP or DIP. Lack of apical bone for implant anchorage was the main reason for not being able to perform IIP and EIP. Complete loss of the buccal bone wall and the need for bone augmentation prior to implant placement were the reasons for not being able to perform DIP. From the results of this retrospective CBCT analysis, DIP is nearly always possible in contrast to IIP and EIP. Therefore, and since it is much easier than IIP and EIP, inexperienced clinicians should mainly focus on ARP and DIP in clinical practice deferring IIP and EIP until more surgical skills have been acquired.

Full-mouth dental implant rehabilitation for a patient suffering from PapillonLefevre syndrome

Papillon-Lefevre syndrome (PLS) is an autosomal recessive disorder that affects the primary and permanent dentitions. It is characterized by severe periodontitis. Titanium implants have emerged as a significant therapeutic option in recent years for both tooth replacement and oral rehabilitation in individuals with PLS. Due to the severe bone loss, these patients may require bone grafting procedures, sinus lifts, and the alveolar ridge splitting technique (ARST) in order to properly position the implants. This report aims to demonstrate how a patient with PLS can be successfully managed for full-mouth rehabilitation with dental implants and hybrid prosthesis. Periodontists and prosthodontists should combine their efforts for an optimal customized treatment plan. Dental implants have been successfully used to restore functionally and esthetically the patient’s mouth.

Enhanced osteointegration and osteogenesis of osteoblast cells by laser-induced surface modification of Ti implants

Dental and orthopedic implants have become routine medical technologies for tooth replacement and bone fixation. Despite significant progress in implantology, achieving sufficient osseointegration remains a challenge, often leading to implant failure over the long term. Nanotechnology offers the potential to mimic the natural patterns of living tissues, providing a promising platform for tissue engineering and implant surface design. Among the various methods for developing nanostructures, High-Regular Laser-Induced Periodic Surface Structures (HR-LIPSS) techniques stand out for their ability to fabricate highly ordered nanostructures with excellent long-range repeatability and production efficiency. In this study, we utilized an innovative technical approach to generate traditional laser-induced superficial LIPSS nanostructures, followed by detailed surface analysis using classical microscopy and physicochemical methods. Our findings demonstrate for the first time that nanostructured LIPSS surfaces can significantly enhance cell adhesion and proliferation while providing an optimal environment for cell metabolism. Given the high reproducibility, low cost, and potential of HR-LIPSS techniques to support cell growth and differentiation, this novel technology has the potential to impact both the industrial development of new implants and clinical outcomes after implantation.

Influence of surface texturing and coatings on mechanical properties and integration with bone tissue: an in silico study.

This investigation delves into the mechanical behaviour of titanium dental implants, a preferred choice for tooth replacement due to their superior reliability over alternative materials. The phenomenon of implant loosening, frequently induced by masticatory activities, underscores the significance of surface modification or texturing to bolster the interaction between the implant and bone tissue. This research comprehensively examines the effects of four distinct surface texturing techniques and five varied bone quality conditions on the biomechanical performance of these implants. The scope of this study is delineated by its focus on implants of diameters 4mm and 6mm, with lengths measuring 9mm and 12mm respectively. Furthermore, the analysis incorporates the evaluation of four different coatings-hydroxyapatite, HA3TO, HA3Sr, and HA1.5TO1.5Sr-to investigate their efficacy in enhancing the osseointegration process on textured surfaces of dental implants. The experimental design entails the assessment of stress distribution within the implant and its coatings, alongside the strain exerted on the surrounding cancellous bone, under the conditions of an average vertical biting force. A comparative analysis between solid implants and those subjected to surface texturing techniques has been conducted. This comparison elucidates the advantageous microstrain profiles presented by certain textured surfaces, which are deemed more conducive to optimal osseointegration. Notably, across all examined textures, the application of hydroxyapatite (HA) and a modified HA composition (HA1.5TO1.5Sr) demonstrates significant improvements in mechanical stability, particularly in scenarios involving weak and very weak bone conditions. This study's findings contribute to the ongoing advancement in dental implant technology, emphasizing the critical role of surface texturing and coating strategies in promoting implant longevity and integration within the biomechanical environment of the human oral cavity.

Treatment of absent maxillary lateral incisors: orthodontic space closure and associated procedures.

Missing maxillary lateral incisors can be treated either with orthodontic space closure or preservation of the edentulous space for tooth replacement. Orthodontic space closure coupled with non-invasive post-orthodontic cosmetic dentistry is a compelling option compatible with optimal function, favourable aesthetics, and periodontal health in the long-term. We present the rationale for space closure and detail contemporary clinical strategies underpinning interdisciplinary treatment planning and excellence in finishing.

Engineered pre-dentin with well-aligned hierarchical mineralized collagen fibril bundles promote bio-root regeneration

Stem cell-mediated bio-root regeneration is an alternative tooth replacement strategy; however, physiologically functional bio-root regeneration with distinctive dentin structure remains challenging. In this study, the distinct arrangements of collagen fibril bundles were identified that account for hierarchical structural differences between dentin, cementum, and alveolar bone. Thus, an “engineered pre-dentin” was fabricated, which was a dentin hierarchical structure mimicking collagen (MC) scaffold, with well-aligned hierarchical mineralized collagen fibril bundles. The results revealed that it has a stronger effect on promoting biological root regeneration in nude mice and miniature pigs with dental pulp stem cell (DPSC) and periodontal ligament stem cell (PDLSC) sheets compared to hydroxyapatite tricalcium phosphate (HA/TCP). The success rate in the MC group was also higher than that in the HA/TCP group (67% and 33%, respectively). In conclusion, the hierarchical dentin-mimicking scaffold can enhance the regeneration of bio-roots, which provides a promising strategy for tooth regeneration.

Primary tooth wear in children from different social environments

Bilingual schools have more hours and high levels of academic demands. Aims: To compare the degree of dental wear and frequency of severe wear facets between children from public rural schools (RG) and children from private bilingual schools in Buenos Aires City (PG). To compare the presence of facets to parents’ reports on bruxism and their opinion on the importance to health of bruxism and snoring. Materials and Method: The sample (n=90) consisted of 5- and 10-year-old children. Their parents/ guardians were asked to complete a structured questionnaire on bruxism and snoring. Children’s degrees of dental wear on primary incisors, canines and molars were identified and recorded. The data were analyzed statistically. Results: The relative risk of wear between PG and RG was 1.82. Bruxism and snoring were reported by 22.9% of the parents/guardians of 5-year-olds and 8.8% of the parents/ guardians of 10-year-olds. In 10-year-olds, significant differences were found between RG and PG for canine wear degree 3 (p=0.01). Conclusions: Children from highly demanding schools presented more dental wear. Higher frequency of severe dental wear was observed in primary canines and molars late in the tooth replacement period regardless of whether sleep bruxism was reported. Parents/guardians from different social conditions considered that bruxism and snoring are important to health to similar degrees.

Trophic evolution in ornithopod dinosaurs revealed by dental wear

Ornithopod dinosaurs evolved numerous craniodental innovations related to herbivory. Nonetheless, the relationship between occlusion, tooth wear rate, and tooth replacement rate has been neglected. Here, we reconstruct tooth wear rates by measuring tooth replacement rates and tooth wear volumes, and document their dental microwear. We demonstrate that total tooth volume and rates of tooth wear increased steadily during ornithopod evolution, with deeply-nested taxa wearing up to 3360 mm3 of tooth volume/day. Increased wear resulted in asymmetric tooth crown formation with uneven von Ebner line increment width by the Late Jurassic, and in faster tooth replacement rates in multiple lineages by the mid-Cretaceous. Microwear displays a contrasting pattern, with decreasing complexity and pit percentages in deeply-nested and later-occurring taxa. We hypothesize that early ornithopods were browsers and/or frugivores but deeply nested iguanodontians were bulk-feeders, eating tougher, less nutritious plants; these trends correlate with increasing body mass and longer gut passage times.

Survival rate and aesthetic outcomes of two-piece zirconia dental implants: A one-year single clinical trial of partially edentulous patients.

Titanium dental implants, traditionally used for tooth replacement, face certain biological and aesthetic limitations. Recently, zirconia has become a notable alternative, valued for its aesthetics and biocompatibility. This study evaluated the efficacy of two-piece zirconia dental implants, particularly their impact on inflammatory cytokines and their survival rate over one year. This study was a single-center, prospective trial and included adults aged 18 and above. 2021-2022, nine two-piece tissue-level zirconia implants were placed in eight patients. Following a three-month osseointegration phase, crowns were cemented. Over a year, we assessed Plaque and Gingival indices, Pocket Depth, and tissue color and texture. Peri-apical radiographs measured bone levels, and IL-1β in peri-implant crevicular fluid (PICF) was quantified using ELISA. Eight subjects (ages 31-63) participated. One implant failed after six months, resulting in a one-year survival rate of 88.8%. Plaque and Gingival indices rose, but peri-implant soft tissue remained stable in color and texture. At 12 months, average bone loss was minimal and insignificant compared to the baseline. IL-1β levels were similar to those at contralateral teeth, with no correlation between IL-1β, Pocket Depth, and Bleeding on Probing. Two-piece zirconia implants emerged as a viable tooth replacement option, with an 88.8% one-year survival rate. They maintained stable soft tissue and bone levels, indicating their potential as effective dental restoratives.

Functional morphology of the pharyngeal teeth of the ocean sunfish, Mola mola.

Many fish use a set of pharyngeal jaws in their throat to aid in prey capture and processing, particularly of large or complex prey. In this study-combining dissection, CT scanning, histology, and performance testing-we demonstrate a novel use of pharyngeal teeth in the ocean sunfish (Mola mola), a species for which pharyngeal jaw anatomy had not been described. We show that sunfish possesses only dorsal pharyngeal jaws where, in contrast to their beaklike oral teeth, teeth are recurved spikes, arranged in three loosely connected rows. Fang-like pharyngeal teeth were tightly socketed in the skeletal tissue, with shorter, incompletely-formed teeth erupting between, suggesting tooth replacement. Trichrome staining revealed teeth anchored into their sockets via a combination of collagen bundles originating from the jaw connective tissue and mineralized trabeculae extending from the teeth bases. In resting position, teeth are nearly covered by soft tissue; however, manipulation of a straplike muscle, running transversely on the dorsal jaw face, everted teeth like a cat's claws. Adult sunfish suction feed almost exclusively on gelatinous prey (e.g., jellyfish) and have been observed to jet water during feeding and other activities; flume experiments simulating jetting behavior demonstrated adult teeth caught simulated gelatinous prey with 70%-100% success, with the teeth immobile in their sockets, even at 50x the jetting force, demonstrating high safety factor. We propose that sunfish pharyngeal teeth function as an efficient retention cage for mechanically challenging prey, a curious evolutionary convergence with the throat spikes of divergent taxa that employ spitting and jetting.

Dental replacement in Caipirasuchus (Crocodyliformes) from the Brazilian Cretaceous

Investigation on dental replacement patterns in three species of Caipirasuchus (Caipirasuchus paulistanus Iori and Carvalho, 2011; Caipirasuchus montealtensis (Andrade and bertini, 2008) and Caipirasuchus mineirus Martinelli et al., 2018), a Crocodyliformes from the Upper Cretaceous of Bauru Basin – Brazil, indicate aspects of their life habits. Caipirasuchus exhibits a posterior-to-anterior replacement teeth direction and numerical alternation in the teeth pattern. Remarkably, Caipirasuchus montealtensis shows replacements occurring even when the functional tooth is absent, possibly due to feeding or combat-related activities. Additionally, an intriguing inverted mandibular replacement in Caipirasuchus montealtensis suggests a unique teeth developmental process. On the other hand, Caipirasuchus mineirus exhibits minimal or no tooth replacements, suggesting a decreased need for dental maintenance in the early stages of life. Despite similarities in replacement patterns, further research is necessary to fully elucidate the lifestyle implications of these findings. This analysis underscores the importance of dental replacement studies in sphagesaurids for understanding their ecological adaptations.

Tooth preservation and "the treatable or hopeless tooth": Re-thinking a concept

The masticatory organ is at the center of dental practice. Tooth loss, regarded as an organ failure, is a core dispute in our profession, as it more often than not does not happen spon-taneously but is influenced by the dentist's treatment plan. Despite the prosthetic possibili-ties of tooth replacement, efforts should be made to preserve as many teeth as possible. Decisions between tooth preservation and extraction are complex and have far-reaching consequences. This article discusses this problem using a clinical case study of a 43-year-old female patient with pronounced localized periodontitis. After a comprehensive diagnosis and treatment planning, a daring regenerative therapy was carried out to try to preserve the tooth. The case shows that even seemingly hopeless teeth can be successfully treated syn-chronously using modern therapeutic approaches. Initial literature data supports the possi-bility of preserving severely compromised teeth in the long term in compliant patients. An integrative treatment approach based on individual patient factors and modern regenerative techniques may well be a viable alternative to tooth extraction and prosthetic restoration, albeit not inexpensive and uncomplicated. This communication emphasizes the need for precise diagnostics, a comprehensive treatment plan, and honest communication with pa-tients about the prospects of success and possible risks, and highlights the strengths of con-sistent tooth preservation.

Brass wire ligation for treatment of the ectopic eruption of the mandibular second molar: a case report.

Ectopic eruption of the second permanent molar is a tooth replacement disorder during adolescence. If not treated in time, it can cause hard tissue of the adjacent first molar resorption, early tooth loss, decreased chewing efficiency, and other serious malocclusions. Timely detection and treatment of ectopic eruption of the second permanent molar are of great significance in preventing malocclusions in adolescents and establishing normal occlusion relationships. However, current case reports on the ectopic eruption of the mandibular second molar are relatively rare and are mostly concentrated on surgical and orthodontic treatments, and long-term follow-up is lacking. This paper reports a case in which brass wire ligation was used to treat ectopic eruption of the mandibular second permanent molar, allowing the permanent teeth to erupt smoothly and establish a normal occlusion. The patient was observed for five years after the operation. The occlusion was stable, and the tooth root development, pulp vitality, and periodontal conditions were normal. This paper provides a clinical approach that is short in treatment duration, simple, and minimally invasive for young mandibular second permanent molars with moderate mesial inclination and partial eruption. This method is of importance in helping children establish physiological occlusion.