Expanding torque possibilities: A skeletally anchored torqued cantilever for uprighting “kissing molars”

Several uprighting mechanics and devices have been used for repositioning tipped molars. “Kissing molars” (KMs) are an uncommon tooth impaction involving 2 severely tipped mandibular molars with their occlusal surfaces positioned crown to crown, with the roots pointing in opposite directions. Orthodontic uprighting of KMs has not been a usual treatment protocol, and it can be a challenging task due to the severe tipping and double impaction, requiring efficient and well-controlled uprighting mechanics. An innovative skeletally anchored cantilever, which uses the torque principle for uprighting tipped molars, is suggested. This torqued cantilever is easy to manufacture, install, and activate; it is a well-known torque that is effective for producing root movement. A successful treatment of symptomatic KMs, involving the first and second molars, was achieved with this cantilever. Thus, clinicians should consider the suggested uprighting mechanics and orthodontic device as a more conservative alternative to extraction of KMs, depending on the patient's age, involved teeth in KMs, tipping severity, and impaction positions. •“Kissing molars” (KMs) are uncommon tooth impactions involving 2 severely tipped mandibular molars.•An innovative skeletally anchored cantilever, which uses the torque principle, is proposed for KM treatment.•KMs were successfully treated, achieving an excellent occlusal balance.•Reasons and guidelines for orthodontic treatment of KMs are discussed.