Dental Tribune Asia Pacific Edition No.6, 2017

Dental Tribune Asia Paciﬁc Edition | 6/2017 TRENDS & APPLICATIONS 19 12 13 14 Figs. 12–14: The mandibular repositioning due to balancing the structures of the temporomandibular joints. “After treatment, the patient was able to protrude her mandible beyond her maxilla.” Editorial note: This article was first published in ortho—international magazine of orthodontics, No. 1, 2017. Dr Luis Carrière is the inventor of the interna- tionally known Carriere SLX bracket and the Carriere Motion appliance. He maintains a private practice in Barce- lona in Spain and can be contacted at luis@carriere.es. AD pect of her maxillary anterior teeth. For this patient, the man- dibular repositioning effected a dramatic, positive change in her facial profile to create a beautiful symmetry (Figs. 11a–g). Figures 12 to 14 illustrate this reposition- ing. An indication of the extent of this movement is the fact that, after treatment, the patient was able to protrude her mandible beyond her maxilla. Case 2 Diagnosis and treatment plan A 27-year-old female patient presented for treatment exhibit- ing a Class II, Division 1, maloc- clusion with a severely protru- sive maxilla and a severely retru- sive mandible (Figs. 6a–e). The patient had had previous ortho- dontic treatment with extrac- tion of the mandibular premo- lars. In consultation with other orthodontists, orthognathic sur- gery was recommended, which she wanted to avoid. The treat- ment plan was to reposition the mandible forward, placing the case into a Class I occlusion (Sagittal First) using the Carriere Motion Clear Class II appliance, then complete treatment utilis- ing light-force archwires in a PSL system. The Motion Clear appli- ance is the latest addition to the family of Motion appliances, de- signed for the patient with high aesthetic demands. Treatment sequence Motion Clear Class II appliance bonded Treatment commenced with the Motion Clear Class II appli- ance bonded directly to the max- illary canines and first molars with 6 oz, 1/4 in. intra-oral elastics for the first month and 8 oz, 3/16 in. elastics for the second and third months, engaged for Class II traction to molar tubes bonded to the mandibular second mo- lars. An Essix 0.04 in. vacu- um-formed retainer was em- ployed in the lower arch for max- imum anchorage. Three months: Class I platform achieved By the end of the first month of sagittal correction, there was already evidence of some de-ro- tation of the maxillary first mo- lars and movement of the buccal segment (molars, premolars and canines) toward a Class I occlu- sion (Figs. 7a–c). Space was also beginning to open between the maxillary incisors. After three months of sagittal correction, the occlusal lock of the Class I platform had been accomplished (Sagittal First) and the case was ready to progress to the next stage (Figs. 8a–c). The Motion ap- pliance was removed. While it would have been easy to finish this case with Invisalign, the pa- tient chose fixed appliances, so Carriere SLX 0.022 in. PSL brack- ets were bonded. Treatment fol- lowed the wire sequence stated in Case 1. The first wire, a 0.014 in. round Cu Nitanium wire, corrected the rotation of the incisors. With the 0.014 × 0.025 in. Cu Nitanium wire, power chain was used to close the spaces between the inci- sors. After these spaces had been closed, the 0.017 × 0.025 in. Cu Nitanium wire began torque con- trol with the final archwire, the 0.019 × 0.025 in. Cu Nitanium wire, to finalise the axial angula- tions of the anterior teeth. When the upper 0.019 × 0.025 in. arch- wire was engaged, three links of power chain were run bilaterally from the second premolar to the first premolar and from the first premolar to a crimpable hook at- tached to the wire distal to the lat- eral incisor to retract the anterior segment, bringing it into the final desired position (Figs. 9a–c). Eleven months: Sagittal and fixed appliance treatment complete With three months of sagittal treatment and eight months of fixed appliance treatment, the case was finished to a harmoni- ous occlusal and facial result (Figs. 10a–c). The result exhibited excellent repositioning of the mandible, held in position by the occlusal lock of the Class I plat- form (intercuspation of the mo- lars, premolars and canines). The mandibular repositioning was obviously not a result of growth in a 27-year-old woman, but the result of balancing the struc- tures of the temporomandibular joints, repositioning the mandi- ble in the temporomandibular space. Prior to treatment, she could not protrude her mandible even to position her mandibular anterior teeth into the lingual as- 第 65 回国際歯科研究学会 65 国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会国際歯科研究学会日本部会 JADR） JADR） JADR） JADR） JADR） JADR） JADR） JADR） JADR） JADR） JADR） JADR） JADR） JADR） JADR） JADR） JADR） JADR） JADR） JADR） JADR）日本部会（JADR）総会・学術大会総会・学術大会総会・学術大会総会・学術大会［日程］ 2017年11月18日（土）・19日（日）［会場］昭和大学　旗の台キャンパス［会場］［会場］［テーマ］［大会長］上條　竜太郎上條　竜太郎上條　竜太郎（昭和大学歯学部口腔生化学講座）（昭和大学歯学部口腔生化学講座） [ 基調講演 ] 森　和俊（京都大学大学院理学研究科教授） [ 特別講演 ] Dr. Angus William G. Walls （President, International Association for Dental Research） Dr. Seong-Ho Choi（President, Korean Division of the International Association for Dental Research） Dr. Harry-Sam Selikowitz （Chair, Science Committee, FDI World Dental Federation） [ シンポジウム ] シンポジウム I 「Cutting-edge etiology of periodontitis: Next sights for host-parasite interaction」シンポジウム II 「Life science in space - biomedical researches performed in the international シンポジウム III 「Advances in iPS cell research and its application to dental medicine」 space station」 [ 審査 ] JADR/GC 学術奨励賞（38 歳未満） JADR/Joseph Lister 賞（歯学部学生） [ 大会事務局 ] 〒142-8555　東京都品川区旗の台 1-5-8 TEL：03-3784-8163　FAX：03-3784-5555 大会ウェブサイト：http://jadr65.umin.jp 責了_The 65th JADRチラシ和文_A4.indd 1 2017/05/23 9:23:26

Dental Tribune Asia Pacific Edition No.6, 2017

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