Fig. 5: Case 1 Pre/Post-treatment CBCT overlay for condylar posi-tion and airway spaces’ dimensions. Positioned posteriorly in the glenoid fossa pretreatment, the patient’s mandibular condyles had moved to a more stable position post-treatment. Note the airway dimension changes that almost doubled from 315mm 2 (pretreatment) to 526mm 2 (post-treatment). Fig. 3: Case 1 Pretreatment. CL II cuspid and molar relationships with deep overbite, an occlusal cant and mild crowding. Fig. 4: Case 1 Sagittal Correction. CL I platform achieved after 5 months’ correction (super CL I platform) with the Carriere Motion 3D Appliance. the start appointment is scheduled, conversion rates drop only 20% but plummet over 50% if no next appointment is scheduled (Fig. 1). The key to garnering solid patient commitment, then, is securing a contract, taking records or bonding an appliance without compromising the most optimal diagnosis and treatment planning. Making Same-Day Starts Practical The solution that makes Same-Day Starts practical is the Carriere ® Motion 3D™ Appliance for sagittal correction (both CL II and CL III). Since sagittal correction is required for a large proportion of orthodon-tic cases, being able to get the A/P correction started at the exam appointment just after records are taken appeals to patients’ need for convenience, ensuring clinical effi-ciency and case conversion. The Motion Appliance (Fig. 2) is used to establish a Class I platform prior to complet-ing treatment with either align-ers or braces. It simplifies finishes and can reduce overall treatment time, including the Fig. 6: Case 1 Post-treatment. Case completed in 14 months with number of align-14 Reveal aligners and 10 Reveal refinement trays. ers employed (Fig. 2a). In plan to indicate its use. We use our terms of adopting Minimum Touch in-house 3D printer to deliver the Orthodontics and keeping conversion opposite arch aligner for anchorage rates high, I strongly believe the the same day. The mess and delay Motion Appliance is an essential tool. of delivering a Herbst-type appli-While just over half of ance are no longer issues. orthodontists continue to use a Presenting the Motion Appliance rigid, fixed functional appliance for versus a Herbst to prospective skeletal Class II correction, and patients is obviously much easier. nearly 75% of those use a Herbst-With the Motion Appliance, patients type appliance 2 , I have found who are undecided about whether to Motion to be effective for both CL complete treatment in braces or II and CL III correction. In my aligners need not make the decision practice, it takes approximately five until after the sagittal correction. minutes of chair time to bond and The Sagittal First philosophy, on there is minimal doctor time for a which the Motion Appliance is proper diagnosis and treatment based, means there are no compet-www.orthodontics.com Winter 2022 9
Journal of the American Orthodontic Society Winter 2022: Page 9
