Treatment of the retained permanent molar.

The effect of five different treatments for retained permanent molars was evaluated in 59 patients to develop a rational guideline for adequate therapy. The results showed that a prosthetic buildup is the proper treatment if retention develops after the growth spurt, because in these cases the extent of infraocclusion is slight and relatively stable. If retention develops before the growth spurt, immediate removal of the retained molar followed by orthodontic treatment is the way to maximal success. When retention develops during the growth spurt, the tooth affected has to be observed at 6-month intervals. In such a case, no active treatment is indicated if the neighboring teeth show no tilting and the extent of infraocclusion is minor and stable. In all other cases, the teeth affected have to be removed, followed by orthodontic closure of the edentulous space. Finally, all patients must be screened regularly, because in this investigation, new cases of retention were observed relatively frequently.