Challenges and Solutions in Molar Verticalisation: A Comprehensive Perspective

Abstract

Molar mesio-inclination represented one of the most frequent malocclusions in adults, mainly attributed to premature tooth loss. This problem affected both dental function and aesthetics, generating bone defects, periodontal pockets and occlusal interferences. Correction by molar verticalisation was essential to restore oral health and optimise prosthetic rehabilitation. The verticalisation process involved significant biomechanical challenges due to the need to apply precise and controlled forces. Devices such as cantilevers, T-springs and mini-implants were used, adjusting to the degree of inclination and periodontal conditions of the patient. Studies showed that the technique chosen depended on factors such as the severity of the inclination, the condition of the bone tissue and the position of adjacent teeth. Research evaluated the periodontal and biomechanical impact of these techniques. Although prolonged tilting did not significantly aggravate moderate periodontitis, plaque accumulation and inflammation were higher in tilted molars. Mini-implants proved to be the most efficient option, minimising periodontal stress and allowing better control of tooth movement. In conclusion, clinical success depended on a comprehensive evaluation that included the type of movement required, the forces applied and the design of the devices used. Proper planning allowed for improved occlusal and periodontal health, ensuring predictable and long-lasting results.