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Main Instructor Kai Lung Wang
Heng Ming Chang
Kwok Hing Ho
Shun Chu Hsieh
Department / Institution Chang Bing Show Chwan Memorial Hospital
Classification Case report
Impaction of permanent second molar is relatively rare, with a reported prevalence ranging from 0%~2.3%. The etiology of impaction is various, involving systemic, local and periodontal factors, as well as developmental disruption of the dental buds. There are several different treatment modalities presented in the literature.
A 12-year-old girl was referred to our department due to bilateral impacted mandibular second molar. Clinical assessment revealed skeletal class II pattern with dental molar Class II relationship and a convex profile. Her upper right second premolar was displaced to palatal aspect and her bilateral mandibular second molars were impacted with mesially inclined. Her bilateral maxillary second molars were also unerupted. We decided to extract four second premolars and underwent orthodontic treatment. At the end of treatment, her impacted teeth were uprighted and well-aligned and her facial profile was improved as well.
Discussion and summary:
In this case, we protracted bilateral mandibular first molars by loop mechanism first to create space for uprighting second molars. Once spaces were sufficient, bilateral mandibular second molars were bonded with molar tubes then levelled with NiTi and stainless steel wires. Early detection and adequate treatment plan are important for a successful outcome of impacted permanent second molar therapy.   
Treatment Modalities for Uprighting Impacted Permanent Second Molar: A Case Report