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  • Writer's pictureDr. Alex

Molar Space Closure

We see lots of patients with large gaps or missing teeth that were extracted early in life. This is a big problem. Teeth on the edges of these spaces can drift and bone in the area can be lost. This makes placement of a dental implant complicated as it can often require orthodontics (to upright adjacent teeth) as well as ridge augmentation procedures (to graft additional bone to support the implant). We had a patient present with 3 missing 1st molar. He wanted an option besides dental implants.

Panoramic x-ray showing spaces where missing teeth used to be

He had 3 missing molars and spaces resulting from these extractions of 6 mm (UR), 11 mm (LR), and 8 mm (LL). You can also see how tipped the molars near these spaces are.

Photo showing patient missing first molars on right side

We determined that the spaces on the right side (6 mm and 8 mm) were good candidates for orthodontic space closure.

Orthodontic microimplants or TADs used to move molars forward

We placed two orthodontic microimplants or temporary anchorage devices (TADs) into the patient's alveolar bone. These implants generally have a diameter of ~2 mm and cause discomfort for 1 day only. After this they are hardly noticeable. The best part of this is you don't need to wear elastics that must be replaced at every meal. The movement happens with minimal fuss.

Final photo showing closed spaces where first molars used to be

Our final intraoral photo shows the large 6 mm and 8 mm gaps we started with are closed! 3rd molars have also moved forward!

Side-by-side panoramic radiographs showing uprighted molars after treatment

Better still the molar roots have been uprighted!

Orthodontic structural superimposition showing maxillary movements (most notably mesial molar movement)

For you dentists and orthodontists: This structural superimposition of the right maxilla shows how far forward the upper right molar moved!

Mandibular structural superimposition showing mesial molar movement

Also for you dentists and orthodontists: This structural superimposition of the right mandible shows how far forward the lower right molar moved! That uprighting!


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