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ePaper created 2017-03-17, 13:11:17 | version 1.38.0
| case report application of the Sagittal First concept Sagittal First Author: Dr Luis Carrière, Spain When Dr Edward Angle first classified malocclu- sions for orthodontic treatment, he created the categories of Class I, Class II and Class III, the principal categories by which cases are still identified today. In founding his classification system on this one dimen- sion—the sagittal dimension—Dr Angle confirmed the sagittal relationship of primary importance and the one most critical and, indeed, most difficult to solve. The Carriere Motion* appliance is a technology that first addresses the patient’s sagittal dimension to establish a Class I platform prior to comprehensive orthodontic treatment. This is accomplished usually within the initial 3 months of treatment. We call this protocol ‘Sagittal First’. Sagittal First eliminates competing force vectors inherent in traditional meth- odologies when traction is employed concurrent with fixed appliance treatment. After establishing a Class I platform in the buccal segments (intercuspation of molars, premolars and canines), the clinician finishes therapy with Carriere SLX** brackets or another finishing appliance of choice, including Invisalign,*** if appropriate. Employing the Sagittal First approach using the Motion Appliance makes achieving high-quality finishes easier and simpler. The purpose of this discussion is to demonstrate application of the Sagittal First concept using the Carriere Motion Appliance to treat Class II and Class III patients. The following two cases offer typical exam- ples of the types of difficult sagittal corrections the Motion appliance can address. Figs. 1a–h: Initial situation: patient’s facial view (a-c); intraoral view (d-f); cephalometric X-ray (g); pantomograph X-ray (h). Fig. 1a Fig. 1b Fig. 1c Fig. 1d Fig. 1e Fig. 1f Fig. 1g Fig. 1h 24 ortho 1 2017