Evaluation of the mandibular retromolar space in orthodontic patients: a review

The retromolar space is an anatomical zone located distal to the last molar and bounded by the anterior border of the ramus of the mandible. This review presents a comprehensive analysis of current scientific data concerning the morphometry and clinical significance of the mandibular retromolar space in orthodontic practice, including issues of its anatomical variability. Anatomical variations, diagnostic methods using cone-beam computed tomography, assessment criteria, factors influencing the volume of the retromolar space, as well as modern approaches to its quantitative measurement are discussed in detail. Particular attention is paid to the role of accurate preliminary analysis of this anatomical zone in the planning and prediction of mandibular molar distalization using various orthodontic techniques, including orthodontic mini-implants, skeletal anchorage, and fixed appliances, which helps to minimize the risk of complications.

Based on the analysis and systematization of published data, we have shown that the mandibular retromolar space should be regarded not as a passive anatomical reserve but as an active biomechanical limit that determines the feasibility, extent, and strategy of molar distalization. The introduction of a standardized protocol for assessing the retromolar space into clinical practice improves the predictability, effectiveness, and safety of molar distalization, expanding the possibilities of non-extraction orthodontic treatment and improving long-term outcomes.