Kim Ki-Jun, Park Jae Hyun, Kim Mi-Jung, Jang Hong-Ik, Chae Jong-Moon
J Clin Pediatr Dent. 2019;43(1):56-63. doi: 10.17796/1053-4625-43.1.11. Epub 2018 Oct 5.
Treatment of horizontally and deeply impacted mandibular molars is challenging for both orthodontists and oral surgeons because of the limited access and anchorage control. We report on two patients who had horizontally and mesially impacted mandibular second molars (MM2s). Both patients were treated by a surgical orthodontic approach, and the crowns of the impacted teeth were brought into the arches by closed forced eruption. Mesially impacted MM2s were uprighted with orthodontic microimplants, inserted in the retromolar area, and then moved into their ideal position. The first patient was in an active growing stage, while the second patient was beyond the active growing stage. Therefore posterior available space (PAS) should be analyzed before treatment of impacted MM2s to prevent periodontal problems after uprighting of impacted teeth. If PAS is not enough for uprighting impacted MM2s, alternative treatment should be considered based on the stage of growth.
由于操作空间有限和支抗控制困难，水平和深度阻生的下颌磨牙的治疗对于正畸医生和口腔外科医生来说都具有挑战性。我们报告了两名患有水平和近中阻生下颌第二磨牙（MM2）的患者。两名患者均采用外科正畸方法进行治疗，通过闭合性强制萌出将阻生牙的牙冠带入牙弓。近中阻生的MM2通过植入磨牙后区的正畸微种植体直立，然后移动到理想位置。第一名患者处于生长活跃期，而第二名患者已过生长活跃期。因此，在治疗阻生MM2之前应分析后牙可用间隙（PAS），以防止阻生牙直立后出现牙周问题。如果PAS不足以直立阻生的MM2，则应根据生长阶段考虑其他治疗方法。
