Comparison of Maxillary First Molar Rotation Among Class I, Class II, and Class III Malocclusions: A Cross-Sectional Comparative Study
DOI:
https://doi.org/10.51253/pafmj.v76iSUPPL-8.14291Keywords:
Maxillary first molar, molar rotation, skeletal malocclusion, Class II malocclusion, sagittal skeletal patternAbstract
Objective: To compare the rotation of the maxillary permanent first molar among patients with Class I, Class II, and Class III malocclusions.
Study Design: Cross-sectional Comparative Study.
Place and Duration of Study: Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from Jan to Dec 2025.
Methodology: This study used a non-probability consecutive sampling technique on 90 cases. Inclusion criteria were the availability of dental casts, cephalograms, and profile photographs, while participants with missing or restored upper first molars, posterior crossbite, excessive wear, or incomplete records were excluded. Age and gender were recorded, and permanent maxillary first molar rotation was measured on dental casts. One-way ANOVA and chi-square tests were used to compare the rotation of permanent maxillary first molars among classes.
Results: The mean age was 21.1±5.9 years. There were 54 females (60%) and 36 males (40%). Participants were equally distributed across skeletal classes, with 30 individuals (33.3%) in each of Classes I, II, and III. The mean permanent maxillary molar rotation differed significantly among classes, with Class II showing the highest rotation (78.7±5.7) compared with Class III (73.4±9.2) and Class I (71.6±3.8) (p<0.001). When categorized as rotation >73°, the proportion of rotated molars was highest in Class II (73%), followed by Class III (47%) and Class I (27%) (p=0.0013).
Conclusion: Permanent Maxillary first molar rotation is significantly associated with sagittal skeletal pattern in untreated young adults. The most pronounced rotation occurs in individuals with skeletal Class II relationships, with a higher prevalence of rotated molars than in Class I o
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References
1. Saghiri M, Eid J, Tang C, Freag P. Factors influencing different types of malocclusion and arch form–A review. J Stomatol Oral Maxillofac Surg 2021; 122(2): 185-191.
http://doi.org/10.1016/j.jormas.2020.07.002
2. Alghamdi M, Tashkandi N. Relationship between Dental Arch Parameters and Mandibular Plane Angle. J Adv Med Dent Sci Res 2022; 10(5): 105-122.
http://doi.org/10.1177/00220345710500043801
3. Parthiban R, Kailasam V, Venkatasamy NS. Rotations of teeth: a systematic review. Front Oral Health 2024; 5: 1484020.
http://doi.org/10.3389/froh.2024.1484020
4. Murugan SM, Kailasam V, Rao GU, Krithika C, Kirthiga M, Aarthi J, et al. Changes in Andrews' fifth key of occlusion (interproximal contacts) before and after orthodontic treatment. J Clin Pediatr Dent 2024; 48(4): 86-98.
http://doi.org/10.22514/jocpd.2024.082
5. Lione R, Paoloni V, De Razza FC, Pavoni C, Cozza P. Analysis of maxillary first molar derotation with Invisalign clear aligners in permanent dentition. Life 2022; 12(10): 1495.
http://doi.org/10.3390/life12101495
6. Rakhshan V, Ghorbanyjavadpour F, Ashoori N. Buccolingual and Mesiodistal Dimensions of the Permanent Teeth, Their Diagnostic Value for Sex Identification, and Bolton Indices. Biomed Res Int. 2022; 2022: 8381436.
https://doi.org/10.1155/2022/8381436
7. De Oliveira Viganó C, da Rocha VE, Junior LRM, Paranhos LR, Ramos AL. Rotation of the upper first molar in Class I, II, and III patients. Eur J Dent 2016; 10(1): 59-63.
http://doi.org/10.4103/1305-7456.175696
8. Özden S, Cicek O. Analysis of the effect of maxillary transverse deficiencies on permanent maxillary first molar rotations using 3D digital models. BMC Oral Health 2025; 25(1): 879.
https://doi.org/10.1186/s12903-025-06301-x
9. Hashemzadeh H, Soleimani M, Golbar M, Dehghani Soltani A, Mirmalek SP. Canine and molar movement, rotation, and tipping by NiTi coils versus elastomeric chains in first maxillary premolar extraction orthodontic adolescents: A randomized split-mouth study. Int Orthod 2022; 20(1): 100601.
https://doi:10.1016/j.ortho.2021.11.002
10. Elfouly D, El-Harouni NM, Ismail HA, El-Bialy T, Ghoneima A. Tip, torque and rotation of maxillary molars during distalization using Invisalign: a CBCT study. BMC Oral Health 2024; 24(1): 797. https://doi.org/10.1186/s12903-024-04529-7
11. Zaoui F, ELHONSALI Y, Mohimd HB, Halimi A. Maxillary molars in class II, derotate or distalize: A systematic review. Al-Rafidain Dent J 2023; 23(1): 53-64.
http://doi.org/10.33899/rdenj.2023.137944.1191
12. Serafin M, Fastuca R, Castellani E, Caprioglio A. Occlusal plane changes after molar distalization with a pendulum appliance in growing patients with Class II malocclusion: a retrospective cephalometric study. Turk J Orthod 2021; 34(1): 10.
http://doi.org/10.5152/turkjorthod.2021.20050
13. Subramanian M, Rajasekaran U, Prabu N, Deepak A, Keerthana V, Priyanka K, et al. Assessment of Dental Arch Width in Individuals With Various Growth Patterns: A Cross-Sectional Study. Cureus 2025; 17(11): e96312.
http://doi.org/10.7759/cureus.96312
14. Maharjan S, Rajbhandari A, Pradhan R, Bajracharya M, Pant BD. Assessment of maxillary first molars rotation in class II malocclusion cases: A cross-sectional study. Orthod J Nepal 2022; 12(2): 15-18. https://doi.org/10.3126/ojn.v12i2.49771
15. Shaheen A, Momina AU, Shahnawaz A, Amin U, Farooq A, Ibrar A. Comparison of maxillary first molar rotation in hyper- and hypodivergent patients. Pak Orthod J 2020; 12(1): 31-35.
https://poj.org.pk/index.php/poj/article/view/282
16. Quinzi V, Tecco S, Nota A, Caggiati E, Mummolo S, Marzo G. Mesial rotation of the upper first molar: association with anterior dental crowding in mixed and permanent dentition. Appl Sci 2020; 10(15): 5301.
https://doi.org/10.3390/app10155301
17. Alexander L, Arun V. Influence of maxillary first molar rotation on the severity of dental class II malocclusion: A cross-sectional study. J Orthod Sci 2023; 12(1):52.
http://doi.org/10.4103/jos.jos_3_23
18. Ugolini A, Bruni A, Abate A, Maspero C, Silvestrini-Biavati F, Lanteri V. Upper arch expansion and spontaneous upper first molar distorotation with Ni–Ti leaf springs and rapid maxillary expander compared to clear aligners. J Orofac Orthop 2026; 31: 1-11. http://doi.org/10.1007/s00056-026-649-7
19. Zhou Y, Wang S, Xu L, Si J, Chen X. Implications of occlusal plane in diagnosis and treatment of malocclusion. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52(2): 237-242.
https://doi.org/10.3724/zdxbyxb-2022-0694
20. Hu H, Lin W, Wu J, Xu H. Research on the correlation between the size of condyle and occlusion plane in skeletal Class II malocclusions. Clin Exp Dent Res 2022; 8(6): 1547-1554.
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