Early mixed dentition treatment of bilateral impaction of permanent mandibular first molars.

Available scientific literature is scarce in covering cases involving impaction of permanent mandibular first molars treated in mixed dentition patients. The purpose of this report was to present the case of a 7-year-old patient with bilateral impaction of permanent mandibular first molars treated early using a simple and effective removable appliance. The proposed intervention involved the construction of a removable acrylic appliance with bilateral titanium-molybdenum alloy distalizing springs to disimpact and allow complete eruption of the molars. A button was bonded to the occlusal surface of each molar to be used as a leverage point for the distalizing springs. Following seven months of treatment, both the permanent mandibular right and left first molars were upright and in physiologic position. This case demonstrates that, when this problem is identified and treated early, pediatric dentists have the opportunity to minimize the complexity of future orthodontic treatment and limit the extent of malocclusion in the permanent dentition.