Distal Movement of Lower Molars with Miniplate Anchorage

The permanent teeth most likely to become impacted are the upper and lower third molars and the upper canines, followed by the lower premolars. Impaction of lower first permanent molars is rare, with an estimated prevalence of .01%. Treatment options include extraction, with or without osseointegrated implant placement, dental luxation, or orthodontic loading; orthodontic treatment with intra- or extraoral devices; and orthodontic extrusion with screws or plates as temporary skeletal anchorage. Because normal eruption of the lower first and second molars is essential for development and coordination of the dental arches and the facial skeleton, a conservative treatment plan aimed at proper positioning of these teeth in the mandibular arch should be considered whenever possible.