The alignment of the second molars is one of the many occlusal goalsof orthodontic treatment. According to the ABO, the permanent secondmolars need to be fully erupted, aligned, and in their final position atthe end of treatment.
Failure to align these teeth during orthodontic treatment may resultin their eruption into an unfavorable transverse (bucco-lingual) orocclusal (vertical) relationship. This may lead to balancing or workingside interferences and, in some cases, an unfavorable proximal contactrelationship with the adjacent first molar. Failure to engage theseteeth during orthodontic treatment may also result in greater anchorageloss, further extrusion of the lower first molars with Class IIelastics, loss of control of nonfunctional second molars,and the significant displacement of the first and second molarsfollowing any type of distalising or tipping mechanics. This is commonlyseen following the use of bite-repositioning appliances using themaxillary first molars as anchors, Class III elastics, reverse curve,and anterior intrusion or extrusion mechanics using the first molars asanchors.
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