Treatment of Impacted First Permanent Molar: A Case Report and 7-Year Follow-Up

Year 2025, Volume: 49 Issue: 3, 184 - 189, 12.12.2025

Selçuk Savaş , Asli Baysal , Ebru Küçükyılmaz İzgi

https://doi.org/10.65022/clindentres.1661289

Abstract

Impaction of the first permanent molars is relatively rare and mostly asymptomatic but a significant clinical challenge in dental practice. The aim of this case report was to present the process of timely treatment of a patient with an impacted first permanent molar using removable appliances. A 6½-year-old female patient was referred for an ankylosed and impacted deciduous second molar (#85) in the right mandibular region and the unerupted permanent molar (#46) in the same area. Intraoral and radiographic examination confirmed #46 was tipped mesially and impacted, and tooth #85 had not erupted. The treatment plan involved extracting the ankylosed and impacted tooth #85, followed by uprightening the mesially tipped tooth #46 to allow its eruption. After the crown of the impacted tooth #46 was surgically exposed, a removable appliance with a spring mechanism was applied to correct its position. Later, treatment continued with a removable appliance that included a distalization screw to continue the movement of tooth #46. After treatment period, the right lower first permanent molar had successfully erupted into its position, the adjacent second premolar had fully erupted, and the contact and occlusion between the teeth were achieved. This case report emphasizes the importance of early diagnosis of eruption problems and highlights the benefits of using removable appliances in the treatment of mesially tipped/impacted mandibular first permanent molars.

Keywords

first molar impaction , impacted firs molar , first molar uphrighting

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