The tilted molar: a prosthetic and periodontal dilemma

The tilted molar presents both prosthetic and periodontal problems. Typically, the loss of a lower first molar or second premolar produces a space and allows the molar, distal to the space, to tilt mesially. The major tilting force is produced by the opposing occlusion. Although a tightly locked occlusion can prevent excessive movement, once the tooth begins to tilt, the vector of force tends to increase the tilting. The severity of both prosthetic and periodontal problems is directly related to the amount of tilting and treatment becomes complex when adjacent teeth begin to migrate.