The therapeutic premise is rather simple, i.e., establish the Class I platform with the appliance that retracts the posterior maxillary segments as a unit and then bond the teeth and complete the treatment. Figure 9 illustrates the Cariérre Distalizer reinforced with Class II elastics, while Figures 10, 11 and 12 display the effects of a patient treated with the appliance.
Figure 9: The Cariérre Distalize reinforced with Class II elastics.
Figure 10: Patient with a Class II malocclusion complicated with a large overjet and deep overbite.
The Cantilever Appliance Clinicians use the cantilever appliance before bonding or banding many teeth with tubes or brackets and uses Class II mechanics for a retraction force. In that respect, it mimics the Carriére Distalizer, but it works by completely different biomechanical principles. The essential parts of the appliance consists of a 4mm hook bonded to the maxillary canine, a tube or band with tubes attached to the molar, and a .slightly long .016 x .022 stainless steel cantilever wire that has a tip-back bend against the molar (Figure 13). When the cantilever wire engages the hook bonded to the canine, the omega loop compresses and puts a distal force against the molar, a mesial force against the canine, while the cantilever simultaneously extrudes and creates a strong clockwise moment against the molar. The cantilever places an intrusive force with no moment on the canine (Figure 14). The addition of Class II mechanics with elastics or NiTi springs will cancel the forces on the canine as seen in Figure 15. Figures 16 through 18 illustrate the results the cantilever appliance can have in the treatment of a Class II malocclusion.
Figure 13: The Cantilever Appliance with a bent and bonded hook on the canine, a banded molar and a slightly long edgewise cantilever wire. Figure 11: Class II correction with Carriére Distalizer. Figure 14: The compression of the loop against the molar tube puts a distal force and a moment on the molar and a forward and upward force on the canine. The yellow arrow is a resultant force from the two forces on the molar.
Figure 15: The addition of the spring or Class II elastic cancels the anterior and intrusive forces on the canine. Figure 12: Completed Cl II therapy with the Carriére Distalizer.