Let’s talk about the Carriere Motion appliance….
This is popular post 6. It is the first time that I wrote about the Carriere motion appliance. I first published this five years ago. It was the first time that I had a real go at this treatment and the KOLs who promoted it. This post has been read many times and is still attracting some attention. I was going to make some changes to it to bring it up to date. However, when I have re evaluated the evidence, this post is still up to date. That is there is no additional “positive” research about this appliance. So, here we go.
One of the new orthodontic developments is the Carriere Motion II appliance for Class II correction. This is getting a lot of publicity, so I thought I should look at it.
Welcome back, my friends, to the show that never ends!
Henry Schein Orthodontics market the Carriere Motion appliance. The theory behind the appliance is that it can be used to correct Class II problems in the first phase of treatment. They call this “sagital first.” This is a similar approach to using a functional appliance to initially correct a Class II occlusion followed by a phase of fixed appliance treatment. As a result, this is not new. The appliance is essentially an upper sectional and bonded bracket on the lower molars with various methods of increasing lower anchorage. The design allows us to use Class II elastics. Here is a cartoon of the appliance working. You can see that it moves the upper buccal segments back, moves the mandible forwards, does something to the TMJ, and increases the airway volume. It truly is a miracle!
We’re so glad you could attend
They make claims on their websites, that the appliance produces more predictable results and shorter treatment times by “up to four months”. (we have heard things like this before). Interestingly, the website also includes statements by the HOS KOLs, for example;.
“We correct the sagittal problem in 3 months and complete the whole treatment in 6-9 months”.
You’ve got to see the show, it is dynamo
They also produced a detailed workbook written by the inventor Luis Carriere. He states that the biomechanics are:
- Distalisation and derotation of the upper first molars
- Distalize maxillary segments
- Create a uniform biomimetric force to establish univectorial dental displacement. (I have absolutely no idea what this means!).
We can use the appliance to treat both adults and children.
You’ve got to see the show, it is rock and roll!
I also came across this short video
This was modestly called “How Sagital First changed orthodontics.” In the video, the HSO general manager, 3 KOLs, and Luis Carriere chatted about the appliance. It is a bit long, but these are some quotes:
“It’s all motion everyday”.
“We are changing faces with little effort”
“The old standard throughout the World was the Herbst, now the Carriere is the new standard”. I thought that this was nonsense…
“Appliance placement is simple with no bands”.
“Since we started using the appliance the patients are happier and the staff are happier”.
“Transformed my life”.
After I watched this, I got the impression that this appliance can do anything!
What did I think?
I think the appliance looks interesting, and some of the case reports look good.
Unfortunately, when I looked for independent case reports, case series, retrospective studies, prospective cohorts, and trials of this great new appliance, I found nothing.
However, I could not help thinking this was just another way of applying Class II mechanics. We can do this with functional appliances and/or elastics. I was also not clear why this appliance was different from simply fitting an upper sectional appliance? Would it change my life? I doubt it.
Would I try it on my patients? I think that I might. Would I tell them that I would be doing shorter, more comfortable, and less hassle treatment to grow their jaws? No, I would not.
Finally, when I look at the videos and marketing, I do not know whether to laugh or cry. What is becoming of orthodontics?
If someone can identify the mid-1970s song, I used for the subheadings they will get a special mention in the next post. Those with memories of the first post may still get this right. But we are all five years older.
Emeritus Professor of Orthodontics, University of Manchester, UK.