Abstract

Molar Uprighting and Intrusion. Alignment of Impacted Teeth

by Wilmes Benedict

Molar uprighting and intrusion are advanced orthodontic techniques often facilitated by TADs (temporary anchorage devices), while alignment of impacted teeth typically requires surgical exposure and biomechanically guided eruption strategies. Molar uprighting is commonly used to correct tilted molars, especially in cases of missing adjacent teeth. Uprighting improves occlusion, facilitates prosthetic rehabilitation, and prevents periodontal complications. Techniques include: • Cantilever mechanics: Using auxiliary wires or springs to apply distalizing and uprighting forces. • TAD-supported uprighting: Mini-implants provide stable anchorage, allowing for controlled root movement without reciprocal effects on adjacent teeth. Molar intrusion is often necessary when supra-erupted molars interfere with prosthetic planning or occlusal harmony. Traditional methods risk extrusion of neighboring teeth, but modern approaches include: • Mousetrap and Mini-Mousetrap appliances: These use mini-implants in the anterior palate with lever arms to intrude maxillary molars effectively while minimizing tipping. • Anterior palatal TADs: Preferred for their low failure rate and biomechanical efficiency, especially in adult patients. Impacted teeth, especially second and third molars, pose challenges due to their position and angulation. Treatment strategies depend on the tooth’s location, depth, and surrounding anatomy: • Surgical exposure and orthodontic traction: The gold standard for aligning impacted teeth. A button or bracket is bonded during surgery, and light forces guide eruption. • Miniscrew-supported pole technique: A recent innovation for impacted second molars. It uses a mesial miniscrew and simple mechanics to apply eruptive forces, achieving high success rates with minimal complications. • Protraction and uprighting of adjacent molars: In cases of missing first molars, second molars can be protracted into the space, and impacted third molars uprighted to restore function. These techniques are transforming complex orthodontic cases into manageable treatments, often avoiding extractions or prosthetic replacements.

Learning Objectives

After this lecture, you will be able to know TAD borne molar intrusion mechanics
After this lecture, you will be able to know molar uprighting mechanics
After this lecture, you will be able to know mechanics for extrusion of impacted teeth