Expanding torque possibilities: A skeletally anchored torqued cantilever for uprighting “kissing molars”

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Abstract

Several uprighting mechanics and devices have been used for repositioning tipped molars. “Kissing molars” (KMs) are an uncommon tooth impaction involving 2 severely tipped mandibular molars with their occlusal surfaces positioned crown to crown, with the roots pointing in opposite directions. Orthodontic uprighting of KMs has not been a usual treatment protocol, and it can be a challenging task due to the severe tipping and double impaction, requiring efficient and well-controlled uprighting mechanics. An innovative skeletally anchored cantilever, which uses the torque principle for uprighting tipped molars, is suggested. This torqued cantilever is easy to manufacture, install, and activate; it is a well-known torque that is effective for producing root movement. A successful treatment of symptomatic KMs, involving the first and second molars, was achieved with this cantilever. Thus, clinicians should consider the suggested uprighting mechanics and orthodontic device as a more conservative alternative to extraction of KMs, depending on the patient's age, involved teeth in KMs, tipping severity, and impaction positions.

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