상·하악 양측 제2대구치의 매복을 동반한 성인 환자의 교정적 견인 치험례

Orthodontic Treatment of an Adult Patient with Bilateral Impaction of Maxillary and Mandibular Second Molars

This case report describes the successful treatment of a 21-year-old male patient with bilateral impaction of the maxillary and mandibular second molars with cystic lesions and apical root resorption of the mandibular first molars. Following the surgical extraction of the third molars and enucleation of the cystic lesions, orthodontic traction was done using a palatal expander as an anchorage unit. Orthodontic traction of the maxillary second molars was achieved by connecting elastic chains to the maxillary anchorage unit to apply a downward force. For the mandibular second molars, intermaxillary elastics were applied between hooks on the maxillary anchorage unit and a traction wire ligated to buttons bonded to the impacted mandibular second molars. Orthodontic treatment achieved functional occlusion without further root resorption of the first molars and contributed to the improvement of alveolar bone levels. Treatment planning for impacted second molars should consider multiple clinical factors, including the patient’s age, stage of root development, tooth morphology, position and angulation, and the presence of third molars. This case demonstrates that orthodontic traction can be a viable alternative to extraction in adult patients, providing both functional occlusion and alveolar bone regeneration.