A Simple Method of Aligning Maxillary Second Molars Toward the End of Treatment

Maxillary second molars fre­quently have not erupted at the time of initial appliance placement. When these teeth do eventually erupt, it is not un­common for them to be buccally displaced relative to the adjacent first molars. A similar situation, where the maxillary first molars roll in palatally, is often encoun­tered as a side effect of a maxil­lary reverse-curve intrusion/ retraction arch.

If this relationship appears toward the end of treatment (Fig. A), attempting to incorporate the second molars in a new archwire may disturb the buccal occlu­sion, especially where offsets have been placed and vertical elastics used to facilitate proper buccal interdigitation.

A simple yet effective alternative is illustrated here. A segment of .018" X .025" stain­less steel wire, about 2/3" long, is inserted through the first molar auxiliary archwire slot (Fig. B), and the protruding distal end is bent down 45° (Fig. C). The wire segment is then pushed through and activated in close proximity to the buccal surface of the second molar (Fig. D).

The main archwire is left in place. Correction of the sec­ond molar position usually takes only four to six weeks, at which time the patient is ready for debonding (Fig. E).