A surgical-orthodontic approach in uprighting impacted mandibular second molars

Johnson, Earl; Taylor, Roger S.

doi:10.1016/0002-9416(72)90156-x

Cited by 19 publications

(16 citation statements)

References 1 publication

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“…Operculectomy, that is the surgical removal of a flap of gum tissue over the partially erupted tooth, is useful in the absence of an alteration of tooth position and angulation and in the presence of a radicular system still under development (indication of a residual eruptive potential) [ 18 , 19 , 20 ]. Most tooth impactions spontaneously solve themselves when hard and/or soft tissue obstacles are removed.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Operculectomy in the Treatment of 145 Cases with Unerupted Second Molars: A Retrospective Case–Control Study

et al. 2020

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The aim of this study is to assess whether operculectomy in patients with retained second molars eases spontaneous tooth eruption in respect to untreated controls. Two hundred and twenty-two patients with delayed eruption of at least one second molar were selected from the archives of the Department of Orthodontics, Milan, Italy. Eighty-eight patients, 40 males and 48 females (mean age 14.8 ± 1.3 years), met the inclusion criteria. Records were then divided into case and control groups. The case group consisted of patients that underwent removal of the overlaying mucosa over second molars (i.e., operculectomy) and the control group consisted of subjects who retained their operculum over an unerupted second molar and were followed for one year without performing any treatment. A total of 145 impacted second molars were considered (75 cases, 70 controls). A risk ratio with 95% confidence interval was used to compare the prevalence of eruption in the two groups. Spontaneous eruption occurred in 93.3% of cases in the operculectomy group (70/75), while in the control group, 10% teeth erupted spontaneously (7/70). Spontaneous eruption in the upper arch occurred in 95.2% of cases among treated patients (40 out of 42), while in the lower arch, spontaneous eruption occurred in 90.9% of cases (30 out of 33). Spontaneous eruption of the upper second molars in the control group occurred in 8.5% of cases (3 out of 35), while in the lower arch, it occurred in 8.5% (3 out of 35). Operculectomy can ease the spontaneous eruption of retained second molars and reduce the chances of inclusion.

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Section: Introductionmentioning

confidence: 99%

Efficacy of Operculectomy in the Treatment of 145 Cases with Unerupted Second Molars: A Retrospective Case–Control Study

et al. 2020

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“…Previous case reports indicate a high incidence of success of surgical uprighting of mandibular second molars without endodontic treatment (6–8). Case selection and careful surgical management of uprighting mandibular second molars are the fundamental criteria to prevent pulp necrosis and root resorption.…”

Section: Discussionmentioning

confidence: 99%

“… Surgical removal of mandibular second molars allowing spontaneous eruption of the third molars into the place of the second molars. There is a risk that the third molars would not erupt into the correct position ( 4 ). Surgical removal of mandibular second molars and transplantation of the third molars into the position of the second molars ( 5 ). Surgical exposure of the mandibular second molars and placement of an orthodontic attachment on the second molar for active orthodontic eruption ( 6, 7 ) with surgical removal of the third molars. Surgical uprighting of the second molars after extraction of the third molars without addition of bone in the mesial defect to allow intact periodontal tissues to achieve normal bone healing ( 8 ). …”

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confidence: 99%

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Bone regeneration after surgical repositioning of impacted mandibular second molars: a case report

Shipper

Thomadakis

2003

Dental Traumatology

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A case is presented where the mesially impacted mandibular second molar teeth were surgically uprighted in an 11-year-old female patient. Bone regeneration is shown in the areas occupied by the impacted second molars with maturation of bone and cortication of the crest of the alveolar bone. The probing depths are also normal with no residual bony defects. This healing was achieved with no bone grafting procedure, emphasizing two important factors: to prevent/minimize any trauma to the tissues at the site of elevation and uprighting of the tooth (i.e. maintaining viable periodontal ligament cells and minimal cementum damage); and to obtain primary closure whilst allowing the tissue in the mesial defect to reorganize against the scaffold of bone. However, the procedure on the one side was complicated with necrosis and infection of the pulp space with external inflammatory root resorption. Endodontic therapy of this tooth proved to be successful with periradicular healing radiographically and re-establishment of the lamina dura. At the 3-year follow-up, the endodontically treated tooth showed no clinical and radiographic signs of pathology. The left second mandibular molar had no pulpal or periodontal postsurgical complications, which may be attributed to apparently more open apices allowing for pulp revascularization after manipulation at the time of surgery. This report illustrates unassisted wound healing that occurs in the area of uprighting with complete reconstitution of periodontal anatomy without additional regenerative procedures to augment bone.

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“…-Brass wire placement/Separating/de-impaction springs [14,26,[33][34][35]] -Orthodontic uprighting [36][37][38] -Allowing the third molar to drift after extraction of the impacted MM2. Although success of this treatment is unpredictable as it depends on the eruption path of the third molar.…”

Section: Overview Of Managementmentioning

confidence: 99%

Surgical uprighting of impacted mandibular second molar: a narrative review

Sangha¹,

Sangha

Hanna³

et al. 2021

J Oral Med Oral Surg

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Early diagnosis of impacted mandibular second molar (MM2) is critical since treatment at a later stage can be complicated. It often requires a multidisciplinary approach. Surgical uprighting of impacted MM2 appears to be a safe, effective, and a reliable alternative to conventional orthodontic mechanics with minimal risk of morbidity or pulpo-periodontal problems. Timely diagnosis is critical and factors affecting treatment outcomes must be assessed for a successful outcome. Although surgical uprighting or repositioning is the most commonly prescribed option for MM2 management, there isn't a review of literature that discusses the etiology, assessment, and surgical management of impacted MM2 with an emphasis on surgical uprighting technique and comparing various factors that affect the outcome.

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A surgical-orthodontic approach in uprighting impacted mandibular second molars

Cited by 19 publications

References 1 publication

Efficacy of Operculectomy in the Treatment of 145 Cases with Unerupted Second Molars: A Retrospective Case–Control Study

Efficacy of Operculectomy in the Treatment of 145 Cases with Unerupted Second Molars: A Retrospective Case–Control Study

Bone regeneration after surgical repositioning of impacted mandibular second molars: a case report

Surgical uprighting of impacted mandibular second molar: a narrative review

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