SECOND MOLAR UPRIGHTING AFTER PREMATURE LOSS OF MANDIBULAR FIRST PERMANENT MOLAR- CASE REPORT

Abstract

Introduction: Uprighting a tipped molar by using an uprighting spring is a fundamental orthodontic treatment technique. Following a weak anchorage done only by the anterior teeth the permanent lower second molar will rotate around its center of resistance, and besides the distalizing movement will occur its extrusion. Following the reaction, the mandibular anterior teeth will have a movement of intrusion. All these elements will lead to anterior open bite. Correction of vertical problems has become easier with the advent of mini-implants. Case presentation:  U.I patient aged 24 years presenting for aesthetic and functional disorders. Clinical examination reveals intraoral Class I molar malocclusion on the right sight, upper narrowing arch with a slight overbite, and the both permanent first molars on the left side lost prematurely. The tooth 37 is inclined at 60⁰ degrees to the plane of occlusion. To avoid front opening occlusion we used an orthodontic miniscrew inserted between the canine and the first premolar on the same side to achieve the second molar up righting. Lower second molar uprighting was achieved without unwanted movements in anterior mandibular region and without molar extrusion. Conclusions: Using mini implants in uprighting a tipped molar will achieve the desired tooth movement and will reduce the number of unwanted side effects and eventually to improve patient’s esthetics.