Abstract
This report details the efficacious treatment of an Angle Class II crowding adult case with an impaction of left mandibular second molar, caused by the left mandibular second and third kissing molars (KMs). A 30-year-old male patient revealed a tonsillar hypertrophy, a deviated nasal septum, and a tongue-thrusting habit. Following diagnosis as an Angle Class II crowding case with a normodivergent skeletal pattern and a skeletal Class I jaw-base relationship, it was determined that the left second mandibular molar was impacted due to the KMs of the left second and third mandibular molars. After expanding the maxillary dentition with MSE and extracting the mandibular second premolars, preadjusted brackets with 0.018” slot was positioned on the mandibular dentition. Six months after the expansion with the MSE and the extraction of the left maxillary second premolar and right first premolar, preadjusted lingual appliance with 0.018” slot was placed on the maxillary dentition. Following extraction of the left mandibular third molar, the left mandibular second molar was surgically exposed and started an orthodontic traction. However, even after 16 months of traction, the tooth remained immobile, indicating the ankylosis. To resolve this, surgical luxation was performed. The left mandibular second molar was then uprighted and extruded to the occlusal plane. The overall duration of treatment was 40 months. A satisfactory and practical occlusion was accomplished, which was maintained for two years during the retention period. This case report shows the long-term stability of a patient treated for impaction of the left mandibular second molar due to the KMs.
