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Carrière Distalizer

Carrière Distalizer

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Published by: api-3705762 on Oct 14, 2008
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he Carrière Distalizer* is a simple and ef fi-cient fixed functional appliance for Class IItreatment (Fig. 1). Developed with advancedcomputer technology, it represents an evolutionof José Carrière’s Modular Sectional Arch.
The Distalizer is most effective in treatingClass II malocclusions without extractions.Brachyfacial patterns respond best to treatment;dolichofacial types are less responsive. The ap-pliance can also be used in many Class I caseswith mesially positioned maxillary molars or,with caution, in Class I cases with premaxillaryhypoplasia. Growing patients are ideal, butadults can be treated as well. Mixed dentitionClass II cases with fully erupted first molars arecandidates for first-phase treatment.
The Carrière Distalizer is designed to cre-ate a Class I molar and canine relationship that Icall a Class I Platform of occlusion. This allowsthe case to be finished with any technique pre-ferred by the orthodontist (Fig. 2). The bio-mechanical objectives of the appliance are as fol-lows:Produce a distal rotational movement of themaxillary first molars around their palatal rootswhen necessary.Simultaneously produce a light, uniform forcefor distal molar movement.Independently move each posterior segment,from canine to molar, as a unit.Eliminate wire changes and thus the distortingcollateral forces that appear with every wire acti-vation in traditional methods.Minimize root resorption.The clinical evidence of the achievement of these objectives will be the appearance of inter-incisal diastemas and wide spaces mesial to thecanines.
 © 2004 JCO, Inc.
A New Class II Distalizer
Fig. 2Maxillary molars are distalized and rotated,providing platform for maxillary canines to oc-clude in Class I relationship.Fig. 1Carrière Distalizer.
*ClassOne Orthodontics, Inc., 5064 50th St., Lubbock,TX 79414.
Appliance Design
The Distalizer is made of mold-injected,nickel-free stainless steel. It is bonded to thecanine and first molar as follows:The
canine pad,
which allows distal move-ment of the canine along the alveolar ridge with-out tipping, carries a hook for the attachment of Class II elastics (Fig. 3). It is connected to an armthat runs posteriorly over the two upper premo-lars in a slight curve. The posterior end of thearm is a ball that articulates in a socket on the
molar pad 
(Fig. 4).This
ball and socket 
were designed withthree-dimensional virtual-reality models
Dr. Carrière is in the private practice of orthodontics at Escuelas Pias,109, 08017 Barcelona, Spain; e-mail: luis@carriere.es. He has afinancial interest in the product described in this article.
Fig. 4Ball-and-socket joint articulates during molar derotation and distalization to limit undesirable move-ments.Fig. 3Carrière Distalizer with Class II elasticattached to hook on canine pad.
resemble the human hip joint, providing maxi-mum freedom of movement in the appropriatedirection. Raised surfaces on the ball articulatewith depressions in the socket, at a maximumorientation of –15°to the longitudinal axis of thearm, to limit undesirable movements and providetorque control over the canine and molar (Fig. 5).This posterior portion of the Distalizeraccomplishes three types of molar movement:1.Uprighting of the crown, if it is mesially in-clined (Fig. 6). Once the molar has been upright-ed, the articulation of the ball with the socketprevents distal tipping.2.Distal rotation around the palatal root. Whenthe maxillary first molar is mesially rotatedaround the palatal root, the molar occlusion mayappear to be Class I, while in reality it is Class IIwith the canines in a cusp-to-cusp relationship(Fig. 7). When the molar has been derotated, theshoulder of the posterior base contacts the mesialarm to prevent overrotation.3.Distal displacement without concurrent distaltipping of the crown (Fig. 8).
Appliance Placement
The Distalizer comes in three dif ferentsizes: 23mm, 25mm, and 27mm. The appropriatesize is determined by measuring from the mid-point of the maxillary first molar’s buccal sur-face to the midpoint of the maxillary caninecrown, using a caliper or a “Dentometer” (Fig.
A New Class II Distalizer
Fig. 6Correction of mesial molar inclination.Fig. 8Bodily distalization of molar, combined withderotation.Fig. 5Ball-and-socket joint provides molar torquecontrol.Fig. 7With mesially rotated maxillary molars,canines cannot occlude in Class I relationship.

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