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optionforboth.Skeletaldiscrepancies are normally treated with a combina- tion of surgery and orthodontics. Many patients reject the option of maxillofacial surgery for many rea- sonshoweverandremainastheyare. Withthisnewapproach,wecanpro- vide a minimally invasive treatment alternative to change their decision and provide them with a substantial facialchangethatstillmaintainstheir facial features. We do not change the patient’sfacecompletely,butwemove the features into a more aesthetically pleasing position. We seek to achieve facial harmony, bringing self-confi- dencetothepatientthroughcompen- sated occlusion, facial improvement andspiritualequilibrium. No TMJ problems have been found at this point and not a single patient has had any problem or symptoma- tology in the TMJ with this approach. In many cases, Class III cases show an additional functional shift of the mandible. While balancing the occlu- sion, we balance the TMJ anatomical structural and functional relations. Thisachievesharmonyinthearea. Are there any studies that have shown the proportion of the mesialisation ef- fect in the upper jaw and of the distali- sationeffectinthelowerjawinthetotal correctionofClassIIIcases? This is a relatively new approach.Wehaveconducted no studies at this point, but in relation to the effect of the Carriere Motion Class II Appliance, together withProf.JamesMcNamarafromUni- versity of Michigan and Prof. Lorenzo Franchi from University of Florence, we are studying our records in order todetermineanswerstothis.Theyare tracing our cases to establish what is going on. Results are expected very soon. We have observed clinically good and stable occlusions over many years.Forexample,youcanseeinmy lectures several cases that have been out of retention for more than ten yearsandarecompletelystable.What we need is an explanation for the experts. What forceelasticsdoyourecommend forchildrenandadults,andwhat is the recommendedwearingtime? Wearing time of elastics with the Motion appliance is 24 hours nor- mally, except for eating. Fresh elastics are re- quired after each meal.In Class III cases, there is a channel between the external and internal cortical bone in the sagittal direction, from mesial to distal. There is no resistance, so sub- stantial force is not required. Instead, weonlyuse6ozelastics. In mixed dentition cases, such as those of 7-year-olds in which we place a Motion Class III Appliance from the mandibular first molar to the mandibular canine, we slightly min- imisetheforce.For4oz,¼inchwillsuf- fice.Wecanincreasethistoupto6oz, ¼inch,ifrequired.Withthistechnolo- gy,significantchangestothepatient’s faceareachieved,resultinginabeauti- fulbalance.ThisoccursinClassIIandIII patients with mixed dentition. You mayaskwhythatis.Theansweristhat wechangetheposteriorocclusalplane and stimulate the orthopaedic effect in a new functional relation. I think thisiskey. What degree of dental Class III maloc- clusion can be corrected with the ap- plianceinchildren? We can completely transform the scenario by controlling the posterior occlusal planes and changing the re- lation between the mandible and the maxilla. There are things that we can- notchangeinourpatients,suchasthe geneticcapacityofthepatienttogrow. Whatwecandofromoursideisevery- thing to direct the growth, to modify the position of the structures and to bringstructuresintoanotherposition in order to try to modify the direction andtochangethescenariocompletely inawaythatwereallyoughtto. To what degree can a dental Class III malocclusion in adults be corrected withtheappliance? We can completely change full-step ClassIIIcasesinadultpatients.Wetreat patients of all ages with this system, fromteenagersto60-year-olds.Skeletal repositioning does not mean skeletal changes but a skeletal repositioning of themandibleinrelationtothemaxilla, as the mandible, specifically the TMJ, is a dynamic anatomical structure. It is very important that we balance that and bring it into a better position. The changes we can achieve in adult cases are amazing. It is a great alternative to surgery in adult cases and something that is going to establish a new treat- mentoptionforClassIIIpatients. You call your new series of lectures “facially driven treatment for Class II and III”.What are your key facts in this matter,and why should the facial,ske- letal and dental factors not be isolated duringtreatment? In orthodontics, we focus on good occlusion of the molars and the ca- nines, looking out for midline correc- tion, overbite, overjet and whether therearetoomanyteeth.Thepatient’s face,teethandbonepositionhavetobe correctly adjusted and balanced. The patienthastobeleftwithanattractive face, as well as facial proportions and relations. We should never forget that behindthefacethereisahumanbeing whowantstobesuccessfulinlife,form natural social relationships and have theopportunitytoestablisharelation- ship with the person he or she has falleninlovewith.Weasorthodontists are fully responsible for the patient’s face and this is very importanttoconsider. The Carriere system is all about this and together with Henry Schein Orthodontics worldwide we are trying to spread this message. We, the ortho- dontists, are able to manage the pa- tient’s soft-tissue profile in a positive way.Howdowedothat?Insteadofusing syntheticmateriallikeanaestheticsur- geon,weconcentrateonboneandteeth andbringthesofttissueintoabetterand morenaturalposition.Wearealsoable to balance the relation between the mandibleandthemaxilla.Bybalancing thepatient’sface,wearealsobalancing his or her life, bringing him or her self- confidenceandrestoringhappiness. However, we could also totally ruin the patient’s life by extracting teeth unnecessarily. I am convinced that nowadays we cannot consider ortho- donticsonlyastreatmentoftheteeth. Ourpatientsarehumanbeingsandwe havetogiverecognitiontothat. With the Carriere system, the Motion appliance, the Carriere SLX bracket,thewiresequence,respectfor the tissue and the physiology of the orthodonticmovement,andconsider- ingthepatient’sface,weaimtobenefit our patients. Many profiles have been affectedinthepast,soourobjectiveis tocreatetoolstobeaddedtotheortho- donticarmamentariumthathelpusin thisdirection. Soyouaresayingthattheorthodontist should place much more emphasis on harmonyofthepatient’sface. The orthodontist is responsible for thepatient’sface.Inmyunderstanding of the specialty, he or she has to be an expertonmovingteethintothecorrect position, as well as on balancing pro- files. He or she is responsible for the harmonisationofthesofttissueand,if necessary,forsculptingthelipswithder- malfillers.Nobodyunderstandsbetter thananorthodontisttheanatomyand proportionality of the lips. Orthodon- tists also have to be experts on the use of Botox for excessive gingival display in those patients with a particularly gummysmile,blockingthelevatorlabii superiorisalaequenasimuscletoretain thecorrectarchforabeautifulsmile. However,wearenotonlyresponsible fortheface.Ithinkwealsohavetotrain societyonthecorrectwaytogainabeau- tiful facial appearance. Instead of seek- ing treatment from an aesthetic sur- geon,theywoulddobettertovisitanor- thodontist.Heorshewillbeabletogive them a natural and elegant aesthetic outcome, including an attractive facial profile.Iftheyarenotsatisfied,theycan always visit an aesthetic surgeon later. Ifsocietycomprehendstheimportance of orthodontics for the face, far more patients will opt for orthodontic treat- ment. That is why we have to start up- grading our specialty. Orthodontics is allaboutaesthetics,artandscience. Thankyouverymuchfortheinterview. Organized by: Official Designation Partner www.wioc2015.com Conference Secretariat: MCI Middle East Tel: +971 4 311 6300, Fax: +971 4 311 6301, Email: wioc2015@mci-group.com Conference Dates: 10 - 13 November 2015 Abstract Submission Deadline: 1 September 2015 30 September 2015 Important Dates Call for Abstracts - Now Open! Abstracts may be submitted via internet using online submission module – www.wioc2015.com Abstracts should be prepared in English. Maximum 2 oral presentations and max. 2 poster presentations by the same presenting author will be accepted for presentation at the Conference Accepted abstracts will be published on the conference website For all enquiries regarding abstracts: please contact wioc2015@mci-group.com AD Ortho Tribune United Kingdom Edition | 1/201512 TRENDS&APPLICATIONS © Henry Schein Orthodontics DTUK0415_34_36_OT10_12_Carriere 18.09.15 13:42 Seite 2 Conference Secretariat: MCI Middle East Tel: +97143116300, Fax: +97143116301, Email: wioc2015@mci-group.com DTUK0415_34_36_OT10_12_Carriere 18.09.1513:42 Seite 2