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Quintessence Publishing: Journals: ORTHODONTICS
ORTHODONTICS
The Art and Practice of Dentofacial Enhancement

Formerly World Journal of Orthodontics

Edited by
Rafi Romano, DMD, MSc (Editor-in-Chief)

ISSN 2160-2999 (print) / ISSN 2160-3006 (online)

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Publication:
Winter 2005
Volume 6 , Issue 1

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Ask an expert:Optimal mechanics for mandibular molar uprighting

Björn U. Zachrisson/Hans-Peter Bantleon

Pages: 80-87
PMID: 15794045

Adult and elderly patients often have molars that are supraerupted and/or mesially tipped. Mesial movement and tipping of mandibular molars after previous extractions may initiate a vicious cycle of traumatic occlusion, functionally disturbing interferences, paralleling dilemmas associated with prosthetic rehabilitation, space problems in conjunction with implant insertion, and periodontal problems. There are several questions of clinical interest related to the orthodontic uprighting and leveling of tipped mandibular molars, such as:

•Is there any evidence-based information that orthodontic uprighting will prevent the progression and acceleration of destructive periodontitis?
•Since tipped molars in some patients may be partly impacted and in other persons extruded above the occlusal plane, will similar tipback methods for molar uprighting frequently have undesirable side effects?
•The most common practical problems in adults occur after mesial tipping and overeruption of mandibular second molars following loss of the first molars. In clinical reports, there are different methods proposed to provide simultaneous molar uprighting and intrusion. Which of these techniques should be preferred for such movements?
•Is it likely that presently available techniques for molar uprighting can be further improved, for example with the addition of temporary miniscrews?

—Kurt Faltin, Jr, São Paulo, Brazil

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