Ortho Tribune U.S. Edition

clusal planes and stimulate the orthope- dic effect in a new functional relation. I think this is the keystone. What degree of a dental Class III can be corrected with the appliance in children? We can completely change the scenario by controlling the posterior occlusal planes and change the relation between the maxilla and mandible. There are things that we can’t change today on our patients: What we can’t change is the ge- netic capacity of the patient to grow, we can’t affect at this point genetics, but what we can do is everything on our side to modify the direction of the growth, to modify the position of the structures and to bring structures into another position in order to try to modify the direction of things and to change completely the sce- nario in a way that we really desire. What degree of a dental Class III can be corrected with the appliance in adults? We can completely change full step Class III’s in our adult patients. We are treat- ing patients of all ages with this system, teenagers, 30s, 40s 50s and older than 60 years old and seeing improvement in facial and dental repositioning. Skel- etal repositioning does not mean skeletal changes, it means a skeletal reposition- ing of the mandible in relation with the maxilla because the mandible and espe- cially the TMJ is a dynamic anatomical structure. And it is very important that we can balance that and bring this in a better position. It’s amazing the change that we can do in adult cases. It’s a great alternative to surgery in adult cases, and it is some- thing that is going to really establish a new scenario for the Class III patients. You call your new series of lectures ‘Facial- ly Driven Treatment For Class II and Class III.’ What are your key facts in this matter and why should the factors facial, skeletal and dental not been isolated during the treatment? Traditionally in orthodontics, we have been focusing a high percentage of our attention on dental interests, looking for good occlusion of the molars, good occlu- sion of the canines, if there is a midline correction, overbite, overjet and some- times focusing too much on teeth. The patient is a human being with a face, with a position of bones, with teeth, and everything has to be correctly adjusted and balanced. So the patient has to have a nice face, a nice facial proportion and relation. We never should forget that behind the face there is a human being who wants to be successful in life, that wants to have nat- ural social relations and wants to have the chance to establish relationships and fall in love. We as orthodontists are fully respon- sible for the face of the patient, and this is very important to highlight. Carrière system is about this and, to- gether with Henry Schein Orthodontics worldwide, we are trying to spread this message. We, the orthodontists, are able to manage the soft tissues of the profile of the patient in a very good way. How we do that? Instead of fulfilling with synthetic material as a cosmetic surgeon does, we use bone and teeth and bring the soft tissues in a better and natural position. We are able to balance the re- lation between the mandible and the maxilla. We are balancing the face of the interview Ortho Tribune U.S. Edition | PCSO PREVIEW 2015 7 patient and behind that we are balancing the life of the patient. We’re giving self- confidence and returning happiness to them. On the opposite, we can totally ruin the life of the patient. How? By extracting teeth that were not necessary to extract. I am totally convinced that today we cannot look only at orthodontics. No more, never again, can we see it as just a set of teeth. The patient is a human being with a face, with fears, with dreams, with proj- ects, and we have to honor that. With the Carrière system, with the Motion appliance, with the Carrière SLX bracket, with the wire sequence, with the respect for the tissues, for the physiology of the orthodontic movement, for the face of the patient, we try to bring benefit to our patients. Many profiles have been affected in the past, so our objective is to create tools to be added to the orthodon- tic armamentarium that help us in this direction. To understand you correctly, the ortho- dontist should put much more emphasize on the patient’s facial harmony. Why? Orthodontics is facial. Orthodontics is face. The orthodontist is responsible for the face of the patient. In my understand- ing of orthodontics, the orthodontist has to be an expert on repositioning teeth in the correct position, repositioning bones in the correct position and balancing pro- files. He is responsible for harmonization of soft tissues and, if necessary, is also an expert who can sculpt the lips with der- mal fillers, because nobody understands better than an orthodontist the anatomy and proportionality of a lip. (Orthodon- tists) should also have expertise on the use of Botox for excessive gingival expo- sition on patients with gummy smiles. So we are responsible for the face and not only that. I think we also have to educate people that if they want to have a beautiful face, instead of going to the cosmetic surgeon, they should start by going to an orthodontist. The orthodontist will be able to give a nice face, a natural and elegant outcome, and if this is not enough change, then as a second option, go to the cosmetic sur- geon. But the first choice should be the orthodontist. If society understands the importance of orthodontics on the face, a big per- centage of new patients will fall into or- thodontics. We have to start upgrading our speciality. Orthodontics is all about esthetics, art and science. Fig. 8a Fig. 8b Figs. 8a, 8b: Initial profile shot (a) and front shot (b) of patient with mixed dentition. Fig. 9a Fig. 9b Fig. 9c Figs. 9a-9c: Initial intraoral shot with integrated Class III Motion appliance. Fig. 10a Fig. 10b Figs. 10a, 10b: Profile shot before (a) and after 10 months of treatment with Class III Motion appliance. Figs. 11a, 11b: Profile shot before (a) and after (b) 10 months of treatment with Class III Motion appliance. Fig. 11a Fig. 11b Ortho Tribune U.S. Edition | PCSO PREVIEW 20157

Ortho Tribune U.S. Edition

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