Unlocking ectopically erupting permanent first molars using light wires

Abstract

Background and overview: Ectopic eruption of permanent molars is one of the challenges that arise in the early mixed dentition period, particularly when the root of the primary second molar is resorbed due to mesial angulation of the impacted first molar. The authors introduce a simple and efficient method to unlock ectopically erupting first molars using a light wire.

Case description: The authors describe the cases of 2 girls (8 and 7 years old) who sought treatment for locking of their maxillary and mandibular first molars, respectively. A 0.012-inch nickel titanium wire was compressed and bonded to the first molars and primary second molars to unlock the first molars. The primary second molars were splinted to the adjacent primary first molars and canines using bonded multistranded wires. As the compressed wires straightened over time, the locked first molars were tipped back without any substantial mesial movement of the primary teeth. After unlocking the molars, the nickel titanium wires were removed to allow spontaneous eruption of the first molars.

Conclusions and practical implications: Although the primary molar roots were considerably resorbed, the ectopically erupting first molars were unlocked successfully without any substantial movement of the primary teeth. The clinical procedure was simple, and no laboratory procedures were needed. In addition, the anchorage burden was reduced with the use of light forces. The authors suggest that primary second molars with substantial root resorption due to ectopic eruption of permanent first molars can be saved simply and efficiently.

Keywords: Ectopic eruption; anchorage burden; first molar; light wire; locking; unlocking.