Eruption Problem

Efficient Treatment of Mesially Impacted Molars
Sung-Hoon Lim

Lecture Description
The purpose of this presentation is to suggest simpler and efficient method for treating mesially impacted molars. Mesially impacted molars develop mainly due to the imbalance between anteroposterior maxillary growth and molar eruption resulting in posterior crowding. Uprighting these molars can be achieved by using simple-tubes. Simple-tube is a generic term for tube-type fixed appliances without bonding base, thus it is bonded to the teeth by applying flowable resin over the tubes. A round NiTi wire segment is inserted into simple-tubes to upright the mesially impacted molars. This simple-tube method is more hygienic due to low and rounded profile and demands less anchorage than conventional methods by using only light NiTi wires. For uprighting mesially impacted molars, lighter uprighting force than conventional methods works well. In severe cases, mini-implants can be used first for molar uprighting especially when the placement of simple-tube is impossible. To upright an impacted mandibular second molar, extraction of the mandibular third molar is required frequently. When mini-implant is needed for traction or uprighting of molars, mini-implant and traction button can be placed at the time of third molar extraction. After uprighting using mini-implants, additional alignment of the uprighted molar is required. Simple-tubes can be used not just to upright impacted molars, but also to move uprighted molars into the ideal position in three-dimensions by positioning simple tubes by deflection-based or force-driven bonding method. Also, wire bending can be incorporated by using twin tubes on anchor tooth to allow double-back wire insertion into the tubes. In this presentation, cases treated by simple-tubes with or without the help of mini-implant will be presented, and benefits and pitfalls of this method will be discussed.