Ectopic molar – detailed

➤ Irreversible impaction of a first permanent molar and E

• An irreversible impaction is when the first permanent molar does not self-correct
• 90% self-correct by age 7 years, almost 10% self-correct by age 8 to 9 years

➤ Ectopic first or second molar

• A radiographically or clinical visible ectopic first or second molar should be investigated for any necessary early intervention.
• At times, the first molars can be intercepted with other concurrent early treatment (e.g. maxillary expansion). Other times, the teeth can be corrected at comprehensive treatment time (e.g. extraction for correction of crowding).

➤ Pathology or obstruction associated with eruption paths

• Supernumeraries, cysts or pathologies around developing molars should be removed to intercept potential ectopic or impacted molars.

➤ Ectopic first molar

• The first molar site is a key functional region of the masticatory system. Treatment to correct their ectopia needs to be considered.

➤ Ectopic second molar

• Ectopic and impacted second molars can cause a deterioration of function and health of adjacent teeth.
• Often a sign of posterior crowding

➤ Impacted third molar with symptoms, pathology or risks

• Whilst every individual is different, NICE 2000 published guidelines on the management of third molars in clinical practice. Surgical removal of third molars should be limited to those with evidence of pathology (caries, pulpitis, cellulitis, abscess, osteomyelitis, cysts etc.).
• If the second molars are impacted/ectopic, a third molar subsitution for the second molars should be evaluated by an orthodontist.