Pacific Coast Society of Orthodontists Bulletin Summer 2020 - 63

Faculty Files

Figure 7. Total arch distalization using an MCPP
molar than when the second molar had erupted.16
However, the presence of a third molar follicle did
not affect distalization. While the maxillary second molar might tip back due to distal movement
of the maxillary first molar, the marginal ridge
discrepancies might be created. Therefore, second
molar mesial marginal ridge elevation could be
a clinical sign of tipping. To prevent such distal
tipping during distalization, the second molars
should be included during the distalization, and
sufficiently stiff wires should be used.17
With traditional types of molar distalizers, it is
known that the third molars can be impacted

Summer 2020    PCSO Bulletin	

when there is distal tipping of the second molars,
and their presence can also impede the distal
movement of the first and second molars. For this
reason, it has been a common practice to extract
the third molars whenever possible when attempting a molar distalization treatment. In our
recent study in 2019,16 we concluded that maxillary total arch distalization caused the unerupted
third molars to move backward and upward,
whereas in the control group, they moved
downward and forward, but the difference in the
posttreatment volume of maxillary tuberosity
was insignificant. We also found that unerupted
third molars tend to move buccally, allowing for

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Pacific Coast Society of Orthodontists Bulletin Summer 2020

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