ORTHODONTIC TREATMENT OF AN IMPACTED MANDIBULAR FIRST MOLAR USING MINIPLATE AS A SKELETAL ANCHORAGE: A CASE REPORT

Impactions can occur because of malpositioning of the tooth bud or obstruction in the path of eruption. However, the exact mechanism is still unknown. The impaction of mandibular first molar is rare with prevalence rates of 0.01~0.25%, but it is important to deimpact the tooth as soon as possible to avoid complications such as dental caries, root resorption, and periodontal problems on the adjacent teeth. Several biomechanical strategies have been proposed for uprighting mesially tipped mandibular first molars. However, most of these have had problems with movement of the anchorage unit because of the reciprocal force. The recent development of skeletal anchorage system(SAS) allows direct application of precise force systems to the target tooth or segment, producing efficient tooth movement in a short time. In this case, an impacted mandibular left first molar with dilacerated roots was treated with a miniplate, which provided skeletal anchorage to upright the tooth. The miniplate was installed in the mandibular ramus, and 10 months after the application of orthodontic force, the impacted tooth was exposed in the oral cavity and uprighted. At this point, the mandibular left first molar was included in the orthodontic appliance with fixed mechanotherapy, the tooth could achieve a normal occlusion. Therefore, the use of SAS simplified the orthodontic procedures and reduced the orthodontic treatment period, and had few side effects.