The overerupting plunger cusp of upper second molars, usually associated with a buccal path of eruption, jeopardizes occlusal relationships. At whatever stage of treatment this becomes apparent, it is not easily or quickly resolved when buccal attachments are employed. The palatal approach is simple and effective.
A hook large enough to accept two elastic loops is bonded to the palatal surface of the second molar. A strand of loops is slipped between the palatal tissue and the Coffin spring of the transpalatal arch. The two end loops are then engaged over the hook with a hemostat, with the desired amount of stretch (Fig. 1). An archwire-directing or ligature-directing instrument is helpful in attaching the second loop to the hook.
At subsequent appointments, the same strand of loops can be stretched to the next loop for continued activation.
