CASE STUDY Y-axis of 71 degrees indicating a neutral growth pattern. His pogo-nion measurement of 0 may grow as much as 3-5mms. His NB-I is 4 mm so during treatment we do not want to move them forward more than a mm or 2 at the most. Fig. 5 ᕦ Improve the patient profile and esthetics and make mom happy. TREATMENT PLAN ᕡ Place upper Gonzalez appli-ance to expand upper arch and distalize the upper molars. ᕢ Place lower right Carriere appliance with Force One and two elastics to distalize the lower right molar to gain room for #27. ᕣ Straight wire bands and brack-ets and archwire sequence. ᕤ Pletcher springs and possibly a posted archwire to get ectopic canines into the archform. ᕥ IRT the ectopic canines to distal. ᕦ Interarch elastics to close and achieve a solid Class I occlusion. ᕧ Maxillary wrap-around Hawley and a bounded lower lingual 3-3. TREATMENT OBJECTIVES After attending the Spring AOS meeting in 2016, I was exposed to a new appliance called the Carriere Motion Appliance. I decided to take the advice of my instructors and treat the Class II molars first with this appliance. I explained to Dane’s mother my reasoning for beginning his treatment with this appliance. ᕡ Start distal movement of the upper molars with a Gonzalez appliance with an expansion screw in the premolar area. This would provide cross arch stability to support the lower Carriere appliance on the lower right. ᕢ Place a lower right Carriere appli-ance to begin distilizing #27. ᕣ Continue both appliances. Dane’s motivation was strong and willing which helped with moving posterior segments distal enough to get #6, 11 and 27 into the arch. ᕤ Align maxillary and mandibu-lar midlines to coincide with the face. ᕥ Obtain a Class I occlusion and observe the six keys of occlu-sion. Fig. 6 24 Fall 2022 JAOS
Journal of the American Orthodontic Society Fall 2022: Page 24
