Second Molar shifting out of alignment. Orthodontist says its fine

[mjbusch]

What would you do if your second molars are out of alignment. The two orthodontists said that it was fine and they will not bracket them. I noticed my old impressions that the second molars are aligned and now they are not I have been wearing braces now for 16 months. Here are some pictures.

Before
After


Here are some links for why they need to be aligned.

Unfortunately, given the many therapeutic difficulties posed by second molars, many doctors opt to take the easy
way out and simply ignore them. Personally, since my philosophy of orthodontics was shaped by the teachings of
Charles Tweed, I feel strong twinges of guilt whenever I am tempted to forget about the second molars. The dictum
I heard in Tweed's Tucson course resonates in my mind every time I do an initial exam: You have to consider all 32
teeth. At the ABO preparatory courses I have attended with my graduate students, the board examiners always
report that more ABO failures can be attributed to poor second molar management than to troubles with any other
tooth.

https://www.jco-online.com/archive/arti ... clenum=243


Do you put braces on the second molars? A lot of orthodontists do not align the second molars. It is critical to the
“bite” or occlusion that they be aligned.

http://www.drdonaseely.com/our-office/h ... ntist.aspx

Many practitioners will bond 2nd molars only if deemed necessary when there is a gross malalignment or rotation
affecting the 2nd molar in relation to the 1st molars – often not from the start – and will not bond them otherwise.
However, with a higher percentage of adult patients seeking orthodontics, we often encounter issues such as
inappropriate buccolingual alignment, mesiodistal tip and axial alignment, incorrect root torque, and marginal ridge
discrepancies with the adjacent first molars. All these issues necessitate correction in order to be able to achieve
optimal results.

https://orthonotes.wordpress.com/2015/0 ... t-to-bond/

Lateral incisors and second molars most often lack adequate alignment

https://www.americanboardortho.com/medi ... nation.pdf

https://books.google.com/books?id=0WIHF ... bo&f=false

One method is to take and pass the American Board of Orthodontics (ABO) phase III examination. Those of you
who have accomplished this milestone realize how much you learn about the general quality of your treatment
results when you start searching for cases that will qualify. Some clinicians wish they would have banded or
bracketed those maxillary second molars so that the alignment and occlusal contacts would be perfect. Others
wonder how they could have missed the mar-ginal ridge discrepancies between the molars and the premolars.

http://www.howtomanuals.net/how-good-are-you.html

[mjbusch]

The data show that some judges, on average, were much more lenient than others and that this resulted in a range
of total scores between 19.7 and 27.5. Most of the deductions were found in the buccal segments and most were
related to the second molars. We present these findings in the context of clinicians preparing for the ABO phase III
examination and for orthodontists in their ongoing evaluation of clinical results.

http://www.pubfacts.com/detail/14580024 ... -frequency

If your orthodontist is not bonding second molars and as a result the occlusion is not as balanced as you think
possible, I would look at this as an opportunity for interdisciplinary collaboration. Call them and with photos in hand
discuss the case and first ask what would happen if the second molars were bonded in that specific case. Hopefully
by problem solving together you will both find a better understanding of the role of second molars in future cases.

https://www.speareducation.com/spear-re ... ar-dilemma

* Do you routinely put bands or brackets on the second molars (12-year molars)?
Placing braces on the second molars is a time-consuming procedure and will increase the cost of materials.
Aligning the 12-year molars is imperative to achieving a healthy, properly functioning bite.

https://www.brownfamilyortho.com/what-sets-us-apart/


Don’t Forget the Second Molars “There is no excuse for failing to address the second molars in our treatment
planning, especially considering the wealth of information available to the practicing orthodontist today. It is up to us
to apply the therapeutic concepts that have already been developed for dealing with these challenging teeth, so that
we can achieve the best possible long-term results for our patients.” - Dr. Robert G. Keim

https://www.linkedin.com/pulse/2nd-perm ... adi-samawi

The results of the four field tests show that the most commonly malaligned teeth were the maxillary and mandibular
lateral incisors and second molars, which accounted for nearly 80% of the mistakes.

https://www.americanboardortho.com/medi ... graphs.pdf