Journal of Prevention and Treatment for Stomatological Diseases ›› 2020, Vol. 28 ›› Issue (10): 641-645.doi: 10.12016/j.issn.2096-1456.2020.10.005

• Cinical Study • Previous Articles     Next Articles

Clinical application of molar uprighting for impacted mandibular second molars

LI Ning1(),YANG Liu2,WANG Hongning1,WANG Tiejun1()   

  1. 1. Department of Orthodontics, Yantai Hospital of Stomatology, Yantai 264000, China
    2. Department of Prosthodontics, Yantai Hospital of Stomatology, Yantai 264000, China
  • Received:2019-11-26 Revised:2020-01-28 Online:2020-10-20 Published:2020-09-01
  • Contact: Tiejun WANG E-mail:yt_lining@163.com;wtj111111@126.com

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Abstract:

Objective To investigate the effect of the clinical application of molar uprighting in the treatment of impacted mandibular second molars. Methods A total of 16 cases of impacted mandibular second molars were chosen, and the impacted molars were treated with straight wire appliances and molar uprighting. Before and after treatment, the vertical angle of the molar, the height of the distal buccal tip, the height of the distal buccal tip of the anchorage molar, the depth of the periodontal pocket and the height of the alveolar bone were measured. Moreover, the treatment cycles of the third molar extraction group, the premolar group and the nonextraction group were compared. Results All impacted molars responded well to treatment. The vertical time of impacted molars was (1.34 ± 0.45) months, (2.20 ± 0.57) months, and (2.30 ± 0.45) months in the third molar extraction group, the premolar extraction group and the nonextraction group, respectively. The treatment time of the third molar extraction group was shorter than that of the other two groups, and the difference was statistically significant (P < 0.05). After treatment, the inclination of impacted second molars increased by (25.94 ± 8.85)°, the elongated distal buccal tip was depressed by (1.00 ± 1.48) mm, the depth of the proximal and middle periodontal pocket of impacted molars decreased by (1.21 ± 1.03) mm, and the height of the alveolar bone of the proximal and middle adjacent surfaces of impacted second molars increased by (4.57 ± 1.45) mm; these differences were statistically significant (P < 0.05). There was no significant difference in the height of the distal buccal tip of the first molar before and after treatment (P > 0.05). Conclusion Molar uprighting is an efficient, reliable, and convenient method that can shorten the treatment period. Extraction of crowded third molars is beneficial for the vertical and periodontal health of impacted second molars.

Key words: orthodontics, impacted teeth, molar uprighting, mandibular second molars, mesially inclined, inclination, height of distal buccal cusp, probing depth of mesial periodontal pocket, height of mesial alveolar bone

CLC Number: 

  • R783.5

Figure 1

Intraoral application of molar uprighting a: the appliance is composed of a cross tube connecting part and a force applying part of TMA wire; b: the long arm of the vertical spring of molars should be bent at different angles according to the vertical requirements of clinical impacted molars. If the molars need to be lowered vertically, the long arm should be bent 135 ° in the near middle"

Figure 2

Measurement of clinical indexes of impacted molars a： inclination measurement of impacted molars; b： height measurement of distal buccal tip; c： height of alveolar bone in impacted molars"

Table 1

Measurement values of various indexes before and after treatment of impacted molars n=16, $\overline{x}±s$"

Impacted molars Pre-treatment After treatment Average change t P
Inclination （°） 63.42 ± 10.31 89.35 ± 3.14 25.94 ± 8.85 3.061 0.002
Height of distal buccal cusp （mm） 25.16 ± 2.59 24.17 ± 2.29 1.00 ± 1.48 2.645 0.008
Distal buccal tip height of anchorage teeth （mm） 28.50 ± 1.40 28.40 ± 1.20 0.10 ± 0.29 1.131 0.258
Probing depth of mesial periodontal pocket （mm） 3.77 ± 1.09 2.52 ± 0.63 1.21 ± 1.03 2.549 0.011
Height of mesial alveolar bone （mm） 11.68 ± 1.91 16.25 ± 0.72 4.57 ± 1.45 3.297 0.001

Figure 3

Upright time of impacted second molar under different extraction methods *: P<0.05"

Figure 4

Typical cases of impacted mandibular second molars treated with vertical appliance a： intraoral photo before treatment; b：CBCT showed that mesial impacted mandibular second molars; c-d： placement of molar uprighting; e： intraoral photo after treatment; f： after treatment, CBCT showed that bilateral second molars were vertical, and no abnormality was found in periodontal alveolar bone"

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