The management of mesially inclined/impacted mandibular permanent second molars

• Published in: Journal of the world federation of orthodontists Vol. 9; no. 3; pp. S45 - S53
• Main Author: Turley, Patrick K.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-10-2020; World Federation of Orthodontists
• Subjects: Dentistry; Mandibular permanent second molar; Mesial impaction; Orthodontic uprighting; Special Clinical; Mandibular permanent second molar; Orthodontic uprighting; Mesial impaction
• ISSN: 2212-4438; 2212-4438
• DOI: 10.1016/j.ejwf.2020.09.004

Mesially impacted mandibular second molars are a common occurrence in orthodontic practices, especially those using the lingual arch or lip bumper for alleviating anterior crowding. Horizontally impacted second molars, on the other hand, occur so infrequently that most practitioners have limited experience in treating such a patient. Because of this there is little consensus on the management of these cases. As opposed to vertically impacted molars that may be associated with ankylosis or other factors preventing eruption, the mesially angulated, horizontally impacted mandibular second molar usually has eruption potential, because its impaction is more commonly due to lack of space and/or abnormal eruption path. Hence, orthodontic uprighting shows the most promise and can commonly be done without extracting the third molar or surgically exposing the impacted second molar. Modern clinicians have at their disposal a myriad of biomechanical choices that can be used to successfully reposition these teeth and enable finishing with an optimal occlusion.