Skeletal Anchorage as a Therapeutic Alternative for Mandibular Second Molar Impaction: A Prospective Case–Control Study

Abstract

Background: The treatment of mandibular second molar (MM2) impaction presents a challenge for orthodontists and requires a surgical–orthodontic approach. This study aims to compare the effectiveness of two techniques for treating impacted MM2: a traditional technique using brass wire and a technique employing skeletal anchorage. Methods: Twelve MM2 with mesio-angular impaction, with an inclination angle between 25° and 40° and an impaction depth between 4 and 10 mm, were selected and randomly divided into two treatment groups. Patients in Group A were treated using the traditional brass wire technique, while those in Group B underwent treatment with a skeletal anchoring technique that utilized a miniscrew positioned in the retromolar region and an elastic sling chain. For both groups, treatment time and the influence of the disimpaction technique on oral health-related quality of life (OHRQoL) were evaluated using the short-form Oral Health Impact Profile (OHIP-14). Results: The results indicated an average treatment time of 168.67 ± 52.32 days for Group A and 76 ± 10.17 days for Group B, with a statistically significant difference (p-value = 0.0002). Regarding the impact on the patients’ OHRQoL, Student’s t-test did not reveal a statistically significant difference between the two groups at 3 and 7 days of follow-up. Conclusions: Both techniques are considered effective for the treatment of impacted MM2 (angulation 25–40°, depth 4–10 mm). The use of skeletal anchorage significantly reduces treatment times without negatively affecting OHRQoL. The results of this study should be confirmed by further studies with larger sample sizes.

Keywords

• impacted mandibular molars
• impacted tooth
• miniscrew
• brass wire
• TADs