When 2nd molar has huge caries or is unrestorable, wisdom tooth can replace the damaged 2nd molar. Even if it is impacted .This case illustrate how easy it is to replace 2nd molar with fully impacted wisdom tooth.
This patient came to my clinic to straighten his front teeth.
Lower right 2nd molar had large caries and it was unrestorable.
Fortunately, the patient had an impacted wisdom tooth. So, it was treatment planned to extract lower right second molar and replace the 2nd molar with the impacted 3rd molar. Part of the extraction space would be used to alleviate anterior crowding.
When the 2nd molar is extracted, how will the impacted wisdom tooth move? How fat will it move? And what direction will it move? Will it get upright by itself?
If the wisdom tooth maintains the angulation, uprighting procedure can be challenging.
Orthodontic miniscrew may be needed.
If the impacted wisdom tooth changes the direction of eruption and get upright slightly, orthodontic treatment can be more straight forward.
It the wisdom tooth get upright using the extraction space, mini-screw will not be needed.
Let’s check the progress.
This was a month after the extraction of decayed 2nd molar. We already start to see the crown of impacted wisdom tooth.
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Lower right wisdom tooth moves really fast. Mo appliance was connected to the 3rd molar.
As long as space is available mesial to the impacted 3rd molar, it moves on its own.
About 10 months after extraction of the 2nd molar, impacted wisdom tooth almost replaced 2nd molar. Although we need to upright it, now we don’t need orthodontic mini-screw. It became very easy case.
In the mean time, the patient was wearing Invisalign. Can you see crowding in the lower anterior got improve a lot?
Were braces used to upright the tooth, and if so, how long did the patient have to wear them?
Until the impacted 3rd molar move mesially and erupt enough as in the video), braces were not used. Now sufficient enamel surface was exposed, The tooth is uprighted with Invisalign.