{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T17:02:37Z","timestamp":1780074157913,"version":"3.54.0"},"reference-count":42,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Simultaneous impactions of first, second, and third permanent molars comprises a very rare clinical situation with diverse therapeutic approaches and is a difficult challenge for dentists. Early diagnosis and treatment of eruption disturbances contributes to optimal outcomes. This article reports the treatment of a teenager with severe impaction of right mandibular first, second, and third molars, which hinders the masticatory function and dental arch integrity. A decision-making process and a simple orthodontic technique are described. To shorten the treatment time and simplify the procedures, the impacted right mandibular third and second molars were orthodontically uprighted with an innovative tip-back cantilever. Subsequently, the deeply impacted right mandibular first molar was extracted with minimal obstacles. The combined surgical-orthodontic approach resolved a challenging clinical problem and eliminated the need for prosthetic or dental implant replacement of the impacted molars. Good occlusion, normal function, and a healthy periodontium of the patient were also achieved.<\/jats:p>","DOI":"10.2319\/062411-409.1","type":"journal-article","created":{"date-parts":[[2011,10,12]],"date-time":"2011-10-12T08:01:38Z","timestamp":1318406498000},"page":"565-571","source":"Crossref","is-referenced-by-count":19,"title":["Management of unilaterally deep impacted first, second, and third mandibular molars"],"prefix":"10.2319","volume":"82","author":[{"given":"Po-Sung","family":"Fu","sequence":"first","affiliation":[{"name":"Visiting Staff, Department of Family Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jen-Chyan","family":"Wang","sequence":"additional","affiliation":[{"name":"Associate Professor, School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Hwei","family":"Chen","sequence":"additional","affiliation":[{"name":"Senior Lecturer, School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ta-Ko","family":"Huang","sequence":"additional","affiliation":[{"name":"Assistant Professor, School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin-Huang","family":"Tseng","sequence":"additional","affiliation":[{"name":"Private practice, Kaohsiung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Cheng","family":"Hung","sequence":"additional","affiliation":[{"name":"Professor and Dean, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-82-3-565-b01","series-title":"Angle Orthod","first-page":"773","article-title":"Prevalence of ectopic eruption, impaction, retention and agenesis of the permanent second molar.","volume":"77","author":"Bondemark, L.","year":"2007","unstructured":"Bondemark, L. and J.Tsiopa. Prevalence of ectopic eruption, impaction, retention and agenesis of the permanent second molar.Angle Orthod2007. 77:773\u2013778."},{"key":"i0003-3219-82-3-565-b02","series-title":"Eur J Orthod","first-page":"31","article-title":"Arrested eruption of the permanent lower second molar.","volume":"21","author":"Vedtofte, H.","year":"1999","unstructured":"Vedtofte, H., J. O.Andreasen, and I.Kjaer. Arrested eruption of the permanent lower second molar.Eur J Orthod1999. 21:31\u201340."},{"key":"i0003-3219-82-3-565-b03","series-title":"Oral Surg Oral Med Oral Pathol","first-page":"420","article-title":"The incidence of unerupted permanent teeth and related clinical cases.","volume":"59","author":"Grover, P. S.","year":"1985","unstructured":"Grover, P. S. and L.Lorton. The incidence of unerupted permanent teeth and related clinical cases.Oral Surg Oral Med Oral Pathol1985. 59:420\u2013425."},{"key":"i0003-3219-82-3-565-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"651","article-title":"Eruption disturbances of the first and second permanent molars: results of treatment in 43 cases.","volume":"116","author":"Valmaseda-Castell\u00f3n, E.","year":"1999","unstructured":"Valmaseda-Castell\u00f3n, E., C.De-la-Rosa-Gay, and C.Gay-Escoda. Eruption disturbances of the first and second permanent molars: results of treatment in 43 cases.Am J Orthod Dentofacial Orthop1999. 116:651\u2013658."},{"key":"i0003-3219-82-3-565-b05","series-title":"J Am Dent Assoc","first-page":"1459","article-title":"Surgical uprighting and repositioning of severely impacted mandibular second molars.","volume":"134","author":"McAboy, C. P.","year":"2003","unstructured":"McAboy, C. P., J. T.Grumet, E. B.Siegel, and A. M.Iacopino. Surgical uprighting and repositioning of severely impacted mandibular second molars.J Am Dent Assoc2003. 134:1459\u20131462."},{"key":"i0003-3219-82-3-565-b06","series-title":"Am J Orthod Dentofacial Orthop","first-page":"86","article-title":"Impacted and ankylosed teeth: why, when, and how to intervene.","volume":"129","author":"Kurol, J.","year":"2006","unstructured":"Kurol, J.\n          \n          Impacted and ankylosed teeth: why, when, and how to intervene.\n          Am J Orthod Dentofacial Orthop\n          2006. 129:86\u201390."},{"key":"i0003-3219-82-3-565-b07","series-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod","first-page":"464","article-title":"Technique to manage simultaneously impacted mandibular second and third molars in adolescent patients.","volume":"103","author":"Motamedi, M. H.","year":"2007","unstructured":"Motamedi, M. H. and H. A.Shafeie. Technique to manage simultaneously impacted mandibular second and third molars in adolescent patients.Oral Surg Oral Med Oral Pathol Oral Radiol Endod2007. 103:464\u2013466."},{"key":"i0003-3219-82-3-565-b08","series-title":"J Dent Sci","first-page":"174","article-title":"Uprighting impacted mandibular permanent second molars with the tip-back cantilever technique.","volume":"3","author":"Fu, P. S.","year":"2008","unstructured":"Fu, P. S., C. H.Lai, Y. M.Wu, et al. Uprighting impacted mandibular permanent second molars with the tip-back cantilever technique.J Dent Sci2008. 3:174\u2013180."},{"key":"i0003-3219-82-3-565-b09","series-title":"Angle Orthod","first-page":"422","article-title":"Impaction and retention of second molars: diagnosis, treatment and outcome.","volume":"79","author":"Magnusson, C.","year":"2009","unstructured":"Magnusson, C. and H.Kjellberg. Impaction and retention of second molars: diagnosis, treatment and outcome.Angle Orthod2009. 79:422\u2013427."},{"key":"i0003-3219-82-3-565-b10","series-title":"Textbook and Color Atlas of Tooth Impactions","first-page":"199","author":"Andreasen, J. O.","year":"1997","unstructured":"Andreasen, J. O., J. K.Petersen, and D. M.Laskin. Textbook and Color Atlas of Tooth Impactions. Copenhagen, DenmarkMunksgaard. 1997. 199\u2013208."},{"key":"i0003-3219-82-3-565-b11","series-title":"Am J Orthod Dentofacial Orthop","first-page":"432","article-title":"Delayed tooth eruption: pathogenesis, diagnosis, and treatment. A literature review.","volume":"126","author":"Suri, L.","year":"2004","unstructured":"Suri, L., E.Gagari, and H.Vastardis. Delayed tooth eruption: pathogenesis, diagnosis, and treatment. A literature review.Am J Orthod Dentofacial Orthop2004. 126:432\u2013445."},{"key":"i0003-3219-82-3-565-b12","series-title":"Orthod Craniofac Res","first-page":"74","article-title":"Genetic analysis of familial non-syndromic primary failure of eruption.","volume":"12","author":"Frazier-Bowers, S. A.","year":"2009","unstructured":"Frazier-Bowers, S. A., D.Simmons, K.Koehler, and J.Zhou. Genetic analysis of familial non-syndromic primary failure of eruption.Orthod Craniofac Res2009. 12:74\u201381."},{"key":"i0003-3219-82-3-565-b13","series-title":"Am J Orthod Dentofacial Orthop","first-page":"160.e1","article-title":"Primary failure of eruption and PTH1R: the importance of a genetic diagnosis for orthodontic treatment planning.","volume":"137","author":"Frazier-Bowers, S. A.","year":"2010","unstructured":"Frazier-Bowers, S. A., D.Simmons, J. T.Wright, W. R.Proffit, and J. L.Ackerman. Primary failure of eruption and PTH1R: the importance of a genetic diagnosis for orthodontic treatment planning.Am J Orthod Dentofacial Orthop2010. 137:160.e1\u2013160.e7."},{"key":"i0003-3219-82-3-565-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"59","article-title":"Determining the cessation of vertical growth of the craniofacial structures to facilitate placement of single-tooth implants.","volume":"131","author":"Fudalej, P.","year":"2007","unstructured":"Fudalej, P., V. G.Kokich, and B.Leroux. Determining the cessation of vertical growth of the craniofacial structures to facilitate placement of single-tooth implants.Am J Orthod Dentofacial Orthop2007. 131:59\u201367."},{"key":"i0003-3219-82-3-565-b15","series-title":"J Oral Rehabil","first-page":"55","article-title":"When should we extract deciduous teeth and place implants in young individuals with tooth agenesis?","volume":"35","author":"Bergendal, B.","year":"2008","unstructured":"Bergendal, B.\n          \n          When should we extract deciduous teeth and place implants in young individuals with tooth agenesis?\n          J Oral Rehabil\n          2008. 35:55\u201363."},{"key":"i0003-3219-82-3-565-b16","series-title":"J Oral Rehabil","first-page":"44","article-title":"Should we extract teeth to avoid tooth-implant combinations?","volume":"35","author":"Lindhe, T.","year":"2008","unstructured":"Lindhe, T.\n          \n          Should we extract teeth to avoid tooth-implant combinations?\n          J Oral Rehabil\n          2008. 35:44\u201354."},{"key":"i0003-3219-82-3-565-b17","series-title":"Am J Orthod Dentofacial Orthop","first-page":"276","article-title":"Molar uprighting with the piggyback buccal sectional arch wire technique.","volume":"99","author":"Kogod, M.","year":"1991","unstructured":"Kogod, M. and H. S.Kogod. Molar uprighting with the piggyback buccal sectional arch wire technique.Am J Orthod Dentofacial Orthop1991. 99:276\u2013280."},{"key":"i0003-3219-82-3-565-b18","series-title":"Am J Orthod Dentofacial Orthop","first-page":"235","article-title":"Uprighting impacted second molars with segmented springs.","volume":"107","author":"Majourau, A.","year":"1995","unstructured":"Majourau, A. and L. A.Norton. Uprighting impacted second molars with segmented springs.Am J Orthod Dentofacial Orthop1995. 107:235\u2013238."},{"key":"i0003-3219-82-3-565-b19","series-title":"J Clin Orthod","first-page":"380","article-title":"Miniscrew treatment of ectopic mandibular molars.","volume":"37","author":"Giancotti, A.","year":"2003","unstructured":"Giancotti, A., F.Muzzi, F.Santini, and C.Arcuri. Miniscrew treatment of ectopic mandibular molars.J Clin Orthod2003. 37:380\u2013383."},{"key":"i0003-3219-82-3-565-b20","series-title":"Am J Orthod Dentofacial Orthop","first-page":"113","article-title":"Treatment of ectopic mandibular second molar with titanium miniscrews.","volume":"126","author":"Giancotti, A.","year":"2004","unstructured":"Giancotti, A., C.Arcuri, and A.Barlattani. Treatment of ectopic mandibular second molar with titanium miniscrews.Am J Orthod Dentofacial Orthop2004. 126:113\u2013117."},{"key":"i0003-3219-82-3-565-b21","series-title":"J Clin Orthod","first-page":"100","article-title":"Uprighting second molars with micro-implant anchorage.","volume":"38","author":"Park, H. S.","year":"2004","unstructured":"Park, H. S., O. W.Kwon, and J. H.Sung. Uprighting second molars with micro-implant anchorage.J Clin Orthod2004. 38:100\u2013103."},{"key":"i0003-3219-82-3-565-b01","series-title":"Angle Orthod","first-page":"773","article-title":"Prevalence of ectopic eruption, impaction, retention and agenesis of the permanent second molar.","volume":"77","author":"Bondemark, L.","year":"2007","unstructured":"Bondemark, L. and J.Tsiopa. Prevalence of ectopic eruption, impaction, retention and agenesis of the permanent second molar.Angle Orthod2007. 77:773\u2013778."},{"key":"i0003-3219-82-3-565-b02","series-title":"Eur J Orthod","first-page":"31","article-title":"Arrested eruption of the permanent lower second molar.","volume":"21","author":"Vedtofte, H.","year":"1999","unstructured":"Vedtofte, H., J. O.Andreasen, and I.Kjaer. Arrested eruption of the permanent lower second molar.Eur J Orthod1999. 21:31\u201340."},{"key":"i0003-3219-82-3-565-b03","series-title":"Oral Surg Oral Med Oral Pathol","first-page":"420","article-title":"The incidence of unerupted permanent teeth and related clinical cases.","volume":"59","author":"Grover, P. S.","year":"1985","unstructured":"Grover, P. S. and L.Lorton. The incidence of unerupted permanent teeth and related clinical cases.Oral Surg Oral Med Oral Pathol1985. 59:420\u2013425."},{"key":"i0003-3219-82-3-565-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"651","article-title":"Eruption disturbances of the first and second permanent molars: results of treatment in 43 cases.","volume":"116","author":"Valmaseda-Castell\u00f3n, E.","year":"1999","unstructured":"Valmaseda-Castell\u00f3n, E., C.De-la-Rosa-Gay, and C.Gay-Escoda. Eruption disturbances of the first and second permanent molars: results of treatment in 43 cases.Am J Orthod Dentofacial Orthop1999. 116:651\u2013658."},{"key":"i0003-3219-82-3-565-b05","series-title":"J Am Dent Assoc","first-page":"1459","article-title":"Surgical uprighting and repositioning of severely impacted mandibular second molars.","volume":"134","author":"McAboy, C. P.","year":"2003","unstructured":"McAboy, C. P., J. T.Grumet, E. B.Siegel, and A. M.Iacopino. Surgical uprighting and repositioning of severely impacted mandibular second molars.J Am Dent Assoc2003. 134:1459\u20131462."},{"key":"i0003-3219-82-3-565-b06","series-title":"Am J Orthod Dentofacial Orthop","first-page":"86","article-title":"Impacted and ankylosed teeth: why, when, and how to intervene.","volume":"129","author":"Kurol, J.","year":"2006","unstructured":"Kurol, J.\n          \n          Impacted and ankylosed teeth: why, when, and how to intervene.\n          Am J Orthod Dentofacial Orthop\n          2006. 129:86\u201390."},{"key":"i0003-3219-82-3-565-b07","series-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod","first-page":"464","article-title":"Technique to manage simultaneously impacted mandibular second and third molars in adolescent patients.","volume":"103","author":"Motamedi, M. H.","year":"2007","unstructured":"Motamedi, M. H. and H. A.Shafeie. Technique to manage simultaneously impacted mandibular second and third molars in adolescent patients.Oral Surg Oral Med Oral Pathol Oral Radiol Endod2007. 103:464\u2013466."},{"key":"i0003-3219-82-3-565-b08","series-title":"J Dent Sci","first-page":"174","article-title":"Uprighting impacted mandibular permanent second molars with the tip-back cantilever technique.","volume":"3","author":"Fu, P. S.","year":"2008","unstructured":"Fu, P. S., C. H.Lai, Y. M.Wu, et al. Uprighting impacted mandibular permanent second molars with the tip-back cantilever technique.J Dent Sci2008. 3:174\u2013180."},{"key":"i0003-3219-82-3-565-b09","series-title":"Angle Orthod","first-page":"422","article-title":"Impaction and retention of second molars: diagnosis, treatment and outcome.","volume":"79","author":"Magnusson, C.","year":"2009","unstructured":"Magnusson, C. and H.Kjellberg. Impaction and retention of second molars: diagnosis, treatment and outcome.Angle Orthod2009. 79:422\u2013427."},{"key":"i0003-3219-82-3-565-b10","series-title":"Textbook and Color Atlas of Tooth Impactions","first-page":"199","author":"Andreasen, J. O.","year":"1997","unstructured":"Andreasen, J. O., J. K.Petersen, and D. M.Laskin. Textbook and Color Atlas of Tooth Impactions. Copenhagen, DenmarkMunksgaard. 1997. 199\u2013208."},{"key":"i0003-3219-82-3-565-b11","series-title":"Am J Orthod Dentofacial Orthop","first-page":"432","article-title":"Delayed tooth eruption: pathogenesis, diagnosis, and treatment. A literature review.","volume":"126","author":"Suri, L.","year":"2004","unstructured":"Suri, L., E.Gagari, and H.Vastardis. Delayed tooth eruption: pathogenesis, diagnosis, and treatment. A literature review.Am J Orthod Dentofacial Orthop2004. 126:432\u2013445."},{"key":"i0003-3219-82-3-565-b12","series-title":"Orthod Craniofac Res","first-page":"74","article-title":"Genetic analysis of familial non-syndromic primary failure of eruption.","volume":"12","author":"Frazier-Bowers, S. A.","year":"2009","unstructured":"Frazier-Bowers, S. A., D.Simmons, K.Koehler, and J.Zhou. Genetic analysis of familial non-syndromic primary failure of eruption.Orthod Craniofac Res2009. 12:74\u201381."},{"key":"i0003-3219-82-3-565-b13","series-title":"Am J Orthod Dentofacial Orthop","first-page":"160.e1","article-title":"Primary failure of eruption and PTH1R: the importance of a genetic diagnosis for orthodontic treatment planning.","volume":"137","author":"Frazier-Bowers, S. A.","year":"2010","unstructured":"Frazier-Bowers, S. A., D.Simmons, J. T.Wright, W. R.Proffit, and J. L.Ackerman. Primary failure of eruption and PTH1R: the importance of a genetic diagnosis for orthodontic treatment planning.Am J Orthod Dentofacial Orthop2010. 137:160.e1\u2013160.e7."},{"key":"i0003-3219-82-3-565-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"59","article-title":"Determining the cessation of vertical growth of the craniofacial structures to facilitate placement of single-tooth implants.","volume":"131","author":"Fudalej, P.","year":"2007","unstructured":"Fudalej, P., V. G.Kokich, and B.Leroux. Determining the cessation of vertical growth of the craniofacial structures to facilitate placement of single-tooth implants.Am J Orthod Dentofacial Orthop2007. 131:59\u201367."},{"key":"i0003-3219-82-3-565-b15","series-title":"J Oral Rehabil","first-page":"55","article-title":"When should we extract deciduous teeth and place implants in young individuals with tooth agenesis?","volume":"35","author":"Bergendal, B.","year":"2008","unstructured":"Bergendal, B.\n          \n          When should we extract deciduous teeth and place implants in young individuals with tooth agenesis?\n          J Oral Rehabil\n          2008. 35:55\u201363."},{"key":"i0003-3219-82-3-565-b16","series-title":"J Oral Rehabil","first-page":"44","article-title":"Should we extract teeth to avoid tooth-implant combinations?","volume":"35","author":"Lindhe, T.","year":"2008","unstructured":"Lindhe, T.\n          \n          Should we extract teeth to avoid tooth-implant combinations?\n          J Oral Rehabil\n          2008. 35:44\u201354."},{"key":"i0003-3219-82-3-565-b17","series-title":"Am J Orthod Dentofacial Orthop","first-page":"276","article-title":"Molar uprighting with the piggyback buccal sectional arch wire technique.","volume":"99","author":"Kogod, M.","year":"1991","unstructured":"Kogod, M. and H. S.Kogod. Molar uprighting with the piggyback buccal sectional arch wire technique.Am J Orthod Dentofacial Orthop1991. 99:276\u2013280."},{"key":"i0003-3219-82-3-565-b18","series-title":"Am J Orthod Dentofacial Orthop","first-page":"235","article-title":"Uprighting impacted second molars with segmented springs.","volume":"107","author":"Majourau, A.","year":"1995","unstructured":"Majourau, A. and L. A.Norton. Uprighting impacted second molars with segmented springs.Am J Orthod Dentofacial Orthop1995. 107:235\u2013238."},{"key":"i0003-3219-82-3-565-b19","series-title":"J Clin Orthod","first-page":"380","article-title":"Miniscrew treatment of ectopic mandibular molars.","volume":"37","author":"Giancotti, A.","year":"2003","unstructured":"Giancotti, A., F.Muzzi, F.Santini, and C.Arcuri. Miniscrew treatment of ectopic mandibular molars.J Clin Orthod2003. 37:380\u2013383."},{"key":"i0003-3219-82-3-565-b20","series-title":"Am J Orthod Dentofacial Orthop","first-page":"113","article-title":"Treatment of ectopic mandibular second molar with titanium miniscrews.","volume":"126","author":"Giancotti, A.","year":"2004","unstructured":"Giancotti, A., C.Arcuri, and A.Barlattani. Treatment of ectopic mandibular second molar with titanium miniscrews.Am J Orthod Dentofacial Orthop2004. 126:113\u2013117."},{"key":"i0003-3219-82-3-565-b21","series-title":"J Clin Orthod","first-page":"100","article-title":"Uprighting second molars with micro-implant anchorage.","volume":"38","author":"Park, H. S.","year":"2004","unstructured":"Park, H. S., O. W.Kwon, and J. H.Sung. Uprighting second molars with micro-implant anchorage.J Clin Orthod2004. 38:100\u2013103."}],"container-title":["The Angle Orthodontist"],"original-title":[],"link":[{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/82\/3\/article-p565.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/82\/3\/article-p565.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/82\/3\/article-p565.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T16:04:28Z","timestamp":1780070668000},"score":1,"resource":{"primary":{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/82\/3\/article-p565.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,5]]},"references-count":42,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.2319\/062411-409.1","relation":{},"ISSN":["0003-3219","1945-7103"],"issn-type":[{"value":"0003-3219","type":"print"},{"value":"1945-7103","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,5]]}}}