![]() ![]() In patients who present with a hyperdivergent facial pattern, a dental or skeletal open bite, or a moderate to severe Class II skeletal or convex profile, engaging the second molars may lead to undesirable side effects. It may not, however, always be feasible or practical to level the posterior aspect of the Curve of Spee by engaging the second molars. This is especially helpful in patients who present with large deep bites, essentially facilitating the leveling of the Curve of Spee. In the majority of cases, simply banding or bonding these teeth leads to their favorable alignment. Second molars are commonly either banded with tubes welded on the buccal aspect or bonded with tubes. How Second Molars Are (and Aren’t) Treatedįigure 1: Some orthodontists use bands with convertible tubes to overcome vertical and transverse discrepancies between the first and second molars.įigure 2: When needed, the tube can be converted into a bracket permanently and the wire secured within the bracket by a steel ligature wire. This is commonly seen following the use of bite-repositioning appliances using the maxillary first molars as anchors, Class III elastics, reverse curve, and anterior intrusion or extrusion mechanics using the first molars as anchors. Failure to engage these teeth during orthodontic treatment may also result in greater anchorage loss, further extrusion of the lower first molars with Class II elastics, 2,3 loss of control of nonfunctional second molars, and the significant displacement of the first and second molars following any type of distalising or tipping mechanics. This may lead to balancing or working side interferences and, in some cases, an unfavorable proximal contact relationship with the adjacent first molar. 1įailure to align these teeth during orthodontic treatment may result in their eruption into an unfavorable transverse (bucco-lingual) or occlusal (vertical) relationship. According to the ABO, the permanent second molars need to be fully erupted, aligned, and in their final position at the end of treatment. The alignment of the second molars is one of the many occlusal goals of orthodontic treatment.
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