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A new rationale for preservation of the mandibular third molar in orthognathic patients with missing molars

Journal of the Korean Association of Oral and Maxillofacial Surgeons / Journal of the Korean Association of Oral and Maxillofacial Surgeons, (P)2234-7550; (E)2234-5930
2022, v.48 no.1, pp.63-67
https://doi.org/10.5125/jkaoms.2022.48.1.63
Un-Bong Baik (Private Practice, Seoul)

Hwa-Sung Chae (Ajou University School of Medicine)
Je-Uk Park (Catholic University of Korea, Seoul)
Stefania Julian (University of Salvador)
Junji Sugawara (Ichiban-Cho Dental Clinic, Sendai)

Abstract

Controversies exist regarding the need for prophylactic extraction of mandibular third molars in patients who plan to undergo orthognathic surgery. An 18-year-old male patient was diagnosed with mandibular prognathism and maxillary retrognathism with mild facial asymmetry. He had a severely damaged mandibular first molar and a horizontally impacted third molar. After extraction of the first molar, the second molar was protracted into the first molar space, and the third molar erupted into the posterior line of occlusion. The orthognathic surgery involved clockwise rotation of the maxil-lomandibular complex as well as angle shaving and chin border trimming. Patients who are missing or have damaged mandibular molars should be monitored for eruption of third molars to replace the missing posterior tooth regardless of the timing of orthognathic surgery.

keywords
Orthodontics, Orthognathic surgery, Sagittal split ramus osteotomy, Temporary anchorage device, Third molar

Journal of the Korean Association of Oral and Maxillofacial Surgeons