Uprighting Of Molars Research Articles

Evaluation of the effect of extraction in comparison to distalization on the maxillary third molars in class II malocclusion: a retrospective study

ObjectiveTo compare the effects of first premolar extraction versus distalization on the vertical position and mesiodistal angulation of maxillary third molars (MxM3) in adolescent class II patients.MethodsThe panoramic x-rays (OPGs) of 200 adolescent class II patients with developing MxM3s were screened. The chosen sample consisted of 2 groups: Group 1 (Distalization) comprising 48 MxM3s, and Group 2 (Extraction) comprising 50 MxM3s. The pre- and post-treatment OPGs were traced to detect the mesiodistal angulation changes of the second molars (MxM2) and MxM3s.ResultsThe angulation and vertical position of the MxM3s at T0 & T1 were also evaluated using Archer’s classification. The distalization group presented a non-significant decrease in the mean angulation of MxM2 and MxM3 (-2.4o & -4.5o uprighting respectively). In the extraction group, both MxM2 and MxM3 presented a highly significant decrease in the mean angulation (-10.5o & -11o uprighting respectively). The angulation and vertical position change of MxM3 significantly improved in the extraction group when compared to the distalization group (P < .001).ConclusionSignificant uprighting and occlusal positioning of the maxillary third molars occurred in the premolar extraction treatment group when compared to the distalization treatment group. The results of the current study highlight the importance of recognizing maxillary third molars during orthodontic treatment planning of Class II malocclusion cases.

Surgery combined with orthodontic treatment for bilateral horizontally impacted mandibular second molars: A case report

Abstract Surgery combined with orthodontic uprighting of impacted mandibular second molars requires sequential treatment procedures. This article presents a rare case of horizontally impacted bilateral mandibular second molars accompanied by dental crowding. The patient’s mandibular second molars were fully embedded in bone with overlying mesially-impacted mandibular third molars and the mandibular first molars were inclined distally. The treatment involved staged bilateral extraction of the second premolars and mandibular third molars, followed by the surgical implantation of micro-implants for anchorage in the mandibular ramus. At a subsequent stage, the mandibular second molars were successfully orthodontically uprighted, leading to a favourable treatment outcome.

Characteristics of Spatial Changes in Molars and Alveolar Bone Resorption among Patients with Loss of Mandibular First Molars: A CBCT-Based Morphometric Study

To investigate the characteristics of spatial changes in molars and alveolar bone resorption among patients with loss of mandibular first molars. A total of 42 CBCT scans of patients with missing mandibular first molars (3 males, 33 females) and 42 CBCT scans of control subjects without loss of mandibular first molars (9 males, 27 females) were evaluated in this cross-sectional study. All images were standardized using the mandibular posterior tooth plane with Invivo software. The following indices regarding alveolar bone morphology were measured, including alveolar bone height, bone width, mesiodistal and buccolingual angulation of molars, overeruption of maxillary first molars, bone defects, and the capability of molar mesialization. The vertical alveolar bone height in the missing group was reduced by 1.42 ± 0.70 mm, 1.31 ± 0.68, and 1.46 ± 0.85 mm on the buccal, middle, and lingual side, respectively (no differences among the three sides; p > 0.05). Alveolar bone width was reduced the greatest at the buccal CEJ level and the least at the lingual apex level. Mandibular second molar mesial tipping (with mean of the mesiodistal angulation = 57.47 ± 10.34°) and lingual tipping (with mean of the buccolingual angulation = 71.75 ± 8.34°) were observed. The mesial and distal cusps of maxillary first molars were extruded by 1.37 mm and 0.85 mm, respectively. Buccal and lingual defects of alveolar bone occurred at the CEJ, mid-root, and apex levels. Through 3D simulation, the second molar cannot be successfully mesialized into the missing tooth position, and the difference between the available and required distances for mesialization was the greatest at the CEJ level. The duration of tooth loss was significantly correlated with the mesio-distal angulation (R = -0.726, p < 0.001), buccal-lingual angulation (R = -0.528, p < 0.001) and the extrusion of the maxillary first molar (R = -0.334, p < 0.05). Both vertical and horizontal resorption of alveolar bone occurred. Mandibular second molars exhibit mesial and lingual tipping. Lingual root torque and uprighting of the second molars are needed for the success of molar protraction. Bone augmentation is indicated for severely resorbed alveolar bone.

Comparison between orthodontic and surgical uprighting of mandibular molars: a systematic review.

To evaluate and compare the efficiency of orthodontic treatment and surgical uprighting of first and second mandibular molars. An electronic literature search in PubMed, Science Direct, Embase, Scopus, Web of Science, Cochrane Library, LILACS, and Google Scholar, as well as a hand search was conducted by two independent researchers to identify relevant articles up to January 2022. In addition, a manual search was done that included article reference lists, grey literature, and dissertations. The risk of bias of the included prospective and retrospective studies was assessed with the Risk Of Bias Tool In Non-randomized Studies of Interventions (ROBINS-I) assessment tool. A total of six nonrandomized clinical trials (non-RCT) evaluating the efficiency of mandibular molar orthodontic and/or surgical uprighting were included. The quality analysis showed certain defects of the Non-RCTs included and, according to the criteria used, the majority of the articles were judged to be of moderate quality. Based on the evidence, orthodontic and surgical uprighting appear to be effective treatment methods for mandibular molars. Surgical uprighting may be associated with more complications than orthodontic uprighting. However, the existing literature on the subject is limited, heterogeneous, and methodologically limited. Therefore, the outcomes should be interpreted carefully.

A Case Treated with Maxillary Molar Distalization through the Maxillary Sinus: Three-Dimensional Assessment with a Cone-Beam Computed Tomography Superimposition

In this report, we describe a successful orthodontic treatment through the maxillary sinus and show the utility of cone-beam computed tomography (CBCT) for this procedure. A 20-year-old man with Class I molar relationships and crowding of the maxillary and mandibular anterior teeth came to us to improve his malocclusion. Maxillary molar distalization was necessary to reduce the crowding of the teeth. This was achieved by the use of temporary anchorage devices (TADs) and the uprighting of the mandibular molars. However, several roots of the maxillary molars protruded into the maxillary sinus. The maxillary sinus is a known barrier to orthodontic tooth movement, leading to root resorption and/or tipping movement. We aimed to distalize the maxillary molars through the maxillary sinus by bodily movement. The findings were three-dimensionally confirmed by using the superimposition of CBCT obtained before and after the treatment.

A cone-beam computed tomography study on strategic uprighting of mandibular molars using a biocreative reverse curve system.

ObjectiveTo analyze the overall treatment effects in terms of the amount of uprighting with changes in the three-dimensional positions of the mandibular posterior teeth after applying the biocreative reverse curve (BRC) system.MethodsThirty-four patients (mean age, 20.5 ± 8.56 years) were treated using the BRC system (mean period, 8.17 ± 2.19 months). Cone-beam computed tomography was performed before treatment and after treatment with the BRC system. The three-dimensional movement of each tooth was analyzed in the coordinate system at points on the crown and root apex. A paired t-test was used to analyze the treatment effects of the BRC system.ResultsThe application of the BRC system spanning from the first premolar to the second molar resulted not only in buccal and distal uprighting, but also in increased buccal and distal tipping of the teeth. The premolars and the first molar were extruded, and the second molar was intruded.ConclusionsWhen the BRC system is applied, simultaneous distal and buccal uprighting of the premolars and molars can be achieved bilaterally using a temporary skeletal anchorage device without unnecessary movement of the anterior teeth.

Evaluation of strategic uprighting of the mandibular molars using an orthodontic miniplate and a nickel-titanium reverse curve arch wire: Preliminary cephalometric study

ObjectiveTo evaluate the overall treatment effects in terms of the amount of uprighting with changes in the sagittal and vertical positions of mandibular molars after applying an orthodontic miniplate with a nickel-titanium (NiTi) reverse curve arch wire (biocreative reverse curve [BRC] system).MethodsA total of 30 female patients (mean age, 25.99 ± 8.96 years) were treated with the BRC system (mean BRC time, 10.3 ± 4.07 months). An I-shaped C-tube miniplate (Jin Biomed) was placed at the labial aspect for the alveolar bone of the mandibular incisors. A 0.017 × 0.025-inch NiTi reverse curve arch wire was engaged at the C-tube mini-plate anteriorly and the first and second premolars and molars posteriorly in the mandibular arch. Pre- and post-BRC lateral cephalograms were analyzed. A paired t-test was used to analyze the treatment effects of BRC.ResultsThe mandibular second molars were intrusively uprighted successfully by the BRC system. Distal uprighting with a controlled vertical dimension was noted on the first molars when they remained engaged in the BRC and the distal ends of the arch wire were laid on the second molars. The mandibular first and second premolars showed a slight extrusion. The changes in the mandibular incisors were unremarkable, while the mandibular molar angulation improved significantly. The lower occlusal plane rotated counterclockwise (MP-LOP 1.13° ± 2.60°).ConclusionsThe BRC system can provide very effective molar uprighting without compromising the position of the mandibular anterior teeth.

Effects of Angle classII correction with the Forsus fatigue resistant device on mandibular third molars : Aretrospective study.

The goal was to evaluate the effects of Angle classII malocclusion treatment using the Forsus fatigue resistant device (FRD, 3M, St. Paul, MN, USA) on the position and angulation of mandibular third molars and retromolar space. In all, 58classII patients (mean age 13.6 ± 1.8years) treated with the FRD (FRD group) were compared with 51classI patients (mean age 13.5 ± 1.6years) who underwent orthodontic treatment (control group). A total of 109 mandibular third molars in the FRD group and 91in the control group were evaluated. Changes in the retromolar space, angulation of the second (ɣ) and third molars (β), and the angle between these teeth (α) were assessed with panoramic radiographs taken at the beginning and the end of the treatment. Data were statistically analyzed. At the end of the treatment, there were significant increases in ɣand βin the FRD group and ɣin the control group (p < 0.05). The decrease in αin the FRD group and increase in the control group were not significant (p > 0.05); however, this change led to asmall significant change between the groups (p < 0.05). The retromolar space significantly increased in the FRD group compared to the control group (p < 0.05). No significant correlation was found between retromolar space and third molar uprighting in any of the groups (p > 0.05). ClassII correction with FRD led to mesialization of the lower arch which provided an increase in the retromolar space. Little improvement in the uprighting of the third molars occurred.

Surgical uprighting and repositioning of unerupted molars: Features and findings of a retrospective sample.

BackgroundSurgical uprighting and repositioning have been proposed to obtain a correct alignment of unerupted permanent molars. A retrospective clinical study was performed to verify the effectiveness of these techniques. Material and MethodsIn order for a case to be included in the study, adequate clinical documentation was required, including radiographic imaging before and after therapy. The degree of inclination of each treated molar was evaluated on pre-operative panoramic radiographs. ResultsFifty-two molars were studied. Molar involvement was more frequent in the mandible (45 cases=86.54%) than in the maxilla (7 cases=13.66%). The mean age of patients treated with completely formed molars was 17.28±2.86, while that of patients with incompletely formed molars was 12.89±1.75. The most frequent position was mesio-angular (39=75%) with a mean inclination of 31.61°±12.9° (range 5.57°-61.26°). Disto-angular molars had a mean inclination of -28.84°±6.49° (range -23.79°- -36.16°). Surgical uprighting was performed in 37 cases (71.15%), while surgical repositioning was performed in 15 cases (28.85%). Three cases were lost during the follow-up. The outcome was positive in the remaining 49 cases. Complications occurred in only 4 surgeries (7.69%). ConclusionsSurgical uprighting and repositioning are reliable therapeutic solutions for unerupted mandibular molars, with a favorable prognosis. Key words:Molar impacted, surgical repositioning, surgical up-righiting, tooth impacted, tooth unerupted.

Surgical uprighting of mandibular second molars: A single-group retrospective cohort study

The management of impacted, unerupted, or malpositioned mandibular secondmolars with orthodontic therapy requires special attention in order to achieve normal anatomic positioning within the dental arch. We present a surgical approach to managing these teeth combining exposure and surgically-assisted forced eruption. This retrospective single-group cohort study followed 260 impacted mandibular secondmolars. The molars were exposed and surgically uprighted. An orthodontic bracket was bonded to aid in orthodontic traction, and the wound was packed to prevent soft tissue growth over the crown of the exposed molar. Patients were followed for a minimum of 6months after uprighting, during which the following outcomes were measured: the degree of success of the eruption one the basis of the clinical occlusal relationship to the opposing dentition, radiographic evidence of bone fill, the periodontal status of the teeth involved, and tooth vitality. A total of 260 mandibular secondmolars were uprighted in 177 patients (83 female, 94 male) with an average age of 14.8years. Outcomes showed that 255molars (98.1%; 95% confidence interval, 96.3-99.8) were successfully uprighted. Complications included infection/abscess in 3molars and fractured root requiring extraction in 2molars. All remaining 255 teeth tested vital, 17 teeth had periodontal pocketing of more than 5mm, and 235 of the teeth had occlusal contact after healing. Surgically-assisted forced eruption with or without orthodontic forced eruption is a safe, successful, and viable approach to managing unerupted or malpositioned mandibular secondmolars in the adolescent population.

Uprighting of impacted second mandibular molars using skeletal anchorage

Uprighting of impacted second mandibular molars using skeletal anchorage

Mesioangular impacted lower third molars: angulation before and after orthodontic treatment with premolar extraction

Impaction of the lower third molars is due to the lack of space in the retromolar pad. Extraction of premolars in orthodontic treatment helps the uprighting of mesioangular impacted third molars so that they can erupt normally. The aim of this study was to measure changes in angulation during orthodontic treatment of mesioangular impacted lower third molars. This retrospective, cross-sectional analytical study used 25 samples of panoramic radiographs from patients aged 10–21 years before and after orthodontic treatment. Angulation was measured using the long axis of the lower second molars as the reference plane. The Wilcoxon test and paired t-test (p < 0.05) showed no significant changes in lower third molar angulation on both sides (p > 0.05). Radiographs showed a tendency for an increase in angulation, although the change was not statistically significant (p > 0.05). These increases occurred most frequently in the adult group (17–21 years old). It can be concluded that the extraction of premolars in orthodontic treatment did not significantly affect the angulation of impacted third molars.

Assessment of Mandibular Third Molar Position by Using Computed Tomography and Reconstructed Lateral Radiograph

Background: Consideration of mandibular third molar is important from orthodontic perspective due to several factors such as, lower anterior arch crowding, relapse in lower anterior region, interference with uprighting of mandibular first and second molars during anchorage preparation and molar distalization. The aims of this study were to assess of gender differences in the mandibular third molar position and compare and evaluate whether there is any differences in the results provided by CT scan and lateral reconstructed radiograph. Materials and Methods: The sample of present study consisted of 39 patients (18 males and 21 females) with age range 11-15 years. CT images for patients who were attending at Al Suwayra General Hospital/the Computerized Tomography department. Computed tomographic images were obtained for The distance from Xi point to distal surface of permanent mandibular second molar was measured in both three dimensional volumetric images and two dimensional CT derived lateral image. The statistical analyses included: means, standard deviations. Paired t-test was used to compare between the two methods and independent t-test was used in verifying the genders difference. Results: The results showed that there was high significant method difference between 3D CT and 2D image and gender differences was observed in values of linear measurements of present study, as males showed higher mean values than females. Conclusion: There is high accuracy of measurement on CT images, so CT scan is advisable during the diagnosis and treatment plan of orthodontic cases.

Dentoskeletal Effects of the Modified Tandem Appliance vs the Facemask Appliance in the Treatment of Skeletal Class III Malocclusion: A Single-center, Randomized Controlled Trial

The aim of this randomized controlled trial was to compare the skeletal and dentoalveolar effects of the modified tandem appliance (MTA) vs the facemask (FM) with rapid maxillary expansion. Thirty-two patients, aged 7 to 9 years were recruited. Eligibility criteria included skeletal class III malocclusion that resulted from the retrusion of the maxilla. Randomization was accomplished to divide the sample into two equal groups to be treated with either MTA or FM. Lateral cephalometric radiographs were obtained before treatment and after 2 mm positive overjet was achieved. Intragroup comparisons were performed using paired-sample t-test, and intergroup comparisons were performed using two-sample t-test at the p ≤ 0.05 level. Thirty-two patients (16 in each group) were available for statistical analysis. The pretreatment variables of both groups were similar. Both treatment therapies showed similar significant increase in the SNA and ANB angles, accompanied by slight decrease in the SNB angle. The increase in the SN:GoMe angle, Bjork's sum, and the overjet were significantly greater in the FM group. The forward movement of upper dentition was similar in both groups. Although the lower incisors retrusion was significantly greater in the FM group than in the MTA group, the uprighting of the lower molars was significantly greater in the MTA group. Both appliances showed similar effects apart from less clockwise rotation of the mandible, less retrusion of the lower incisors, and greater uprighting of the lower molars in the MTA group. Both the MTA and the FM groups are effective in treating class III malocclusion. The MTA group is more efficient in controlling the clockwise rotation and gaining some space in the lower arch.

Surgical Uprighting of Mandibular Second Molars

Surgical Uprighting of Mandibular Second Molars

Effects of Extraction and Nonextraction Treatment on Third Molar Angulation

ABSTRACTObjectiveTo compare the angular changes in the developing third molars in both first premolar extraction and nonextraction cases and to determine if premolar extraction results in greater mesial movement of mandibular buccal segment and also causes favorable rotational changes in the third molar tip, which can improve later eruption of the third molars.Materials and MethodsPretreatment (T1) and post-treatment (T2) panoramic radiographs were obtained 31 subjects were taken who had been treated by extraction of all first premolars and for 21 subjects treated with nonextraction theray. Occlusal plane was used to measure and compare the changes in the angles of the developing maxillary and mandibular third molars.ResultsThe mean uprighting of the third molars seen in the extraction group was 8.7° ± 10.29° and 2.97° ± 11.11° on the right side, and 5.14° ± 9.04° and 2.77° ± 12.10° on the left side following treatment (T2 – T1). For the nonextraction group, the mean difference was – 1.52 ± 6.43 and – 6.430 ± 12.21° on the right side, and – 3.90° ± 7.67° and – 5.7° ± 7.23° on the left side. There was a statistically significant difference between the groups (p &lt; 0.001).ConclusionPremolar extractions had a positive influence on the developing third molar angulations. Nonextraction therapy did not have any adverse effects.How to cite this articleNitturkar AS, Doshi S, Krishnan RV, Karandikar G, Tahilramani S, Gandhi B. Effects of Extraction and Nonextraction Treatment on Third Molar Angulation. J Contemp Dent 2015;5(1):17-21.

Influence of treatment including second molars on final and postretention molar angulation

Evaluate axial mesiodistal inclinations of the mandibular molars in orthodontically treated cases, analyzing whether inclusion of second mandibular molars in treatment mechanics has any influence on final and postretention molars angulations. The sample comprised 150 panoramic radiographs of 50 patients. Patients were treated with extraction of four first premolars and divided into 2 groups: Group 1 comprised 25 subjects without inclusion of mandibular second molars during orthodontic treatment, whereas Group 2 comprised 25 subjects with inclusion of mandibular second molars. Panoramic radiographs at three observation times were evaluated: pretreatment, posttreatment and postretention. The statistical analysis included one-way analysis of variance (ANOVA) for intragroup evaluation and independent t-tests for intergroup comparisons. Intragroup analysis demonstrated significant uprighting of mandibular first and second molars during treatment in Group 2, which remained stable during the postretention stage. Intergroup comparison demonstrated that Group 2 presented first and second molars significantly more uprighted in relation to Group 1 in both post-treatment and postretention stages. It was concluded that inclusion of mandibular second molars in the orthodontic mechanics is relevant not only to correct the angulation of these teeth, but also to aid mandibular first molars uprighting.

Uprighting of mandibular second molars with the sectional modified Loca system

A new way to upright the mandibular second molar is described. The principles of the Loca system, originally used for molar distalization, are employed in the mandibular arch.

Residents' journal review

Residents' journal review

Soft Tissue and Occlusal Management in the Surgical Uprighting of Impacted Molars: Technical Note

A The treatment of impacted mandibular second molars (Fig 1) is a common problem faced by oral and maxillofacial surgeons and orthodontists. Bringing the impacted tooth into its correct position in the dental arch is important in the prevention of caries and periodontal problems on the distal root of the first molar and in preventing arch-length discrepancies. Orthodontic uprighting, with or without the use of temporary anchorage devices, has limitations, including a lack of access to the crown for the placement of an orthodontic appliance and the difficulty in applying appropriate directional force. Other variables that affect successful orthodontic uprighting include the experience of the orthodontist, the age of the patient, the degree of root formation, and the depth of the impaction. Surgically assisted uprighting provides access to bond an orthodontic bracket, decreases the need for complex mechanics, and significantly shortens orthodontic treatment time. Complications of surgical uprighting include the possibility of root fracture, devitalization resulting in inflammatory or replacement resorption, and the possible need for endodontic therapy. Numerous publications in the literature have reported high levels of success for this procedure, with minimal morbidity. Several techiques have been described, with the primary diference being whether or not the third molar is emoved to allow distal movement of the second