崇愛牙醫診所(資料重建中,歡迎新舊朋友)

這是凱利遠心移動棒(carriere distalizer)於口內就位的情形,配掛橡皮筋於上顎犬齒的掛鉤上,下顎則掛在大臼齒的頰面管(buccal
tube)上,利用咀嚼,說話,口腔運動的力源,來做6543/3456的整體後退運動,以改善前牙的突度,進一步內收

注意看下面的動畫,上顎第一大臼齒由近心轉位到達一類關係的圖示( CL I  PLATFORM),大臼齒變得處於較方正的位置

下顎的支抗=錨定(anchorage)的提供,在兩邊6/6band上焊接lingual arch(舌弓)連接以做為抵抗上顎配掛橡皮筋遠移6543/3456的支撐力量,下顎因為具有輕微的擁擠,所以在咬合不干擾的情況下,做先期的整平排齊,一般是只有6-6+lingual arch的

這是凱利遠心移動棒的包裝(右上的黑色包裝物),上頭是犬齒到第一大臼齒的量尺,下端圓型物裡有左右各3種型號的distalizer(23,25,27mm),左上是TOMY公司產的elastics,6mm
1/4" M6的橡皮筋以做為牽引之用,左下的是凱利矯正器(這是CLASS  ONE公司產的包裝),右下是舌弓的工作模型,中間是BLACK DIAMOND
WIRE(0.014")

再看一次裝配遠心移動棒的所需要的裝置,左邊是記存模型(STUDY
MODEL),中間上是中信國際代理的american orthodontics的sea lion  (海獅) 6  1/2 oz 
heavy的橡皮筋,中下的是carriere SLB自鎖式矯正器 +遠心移動棒(左/右)
,右側是工作模型,焊接舌弓與弓線

遠心移動棒新包裝(2008年)

●遠心移動棒在eating& chewing(吃飯與咀嚼)時不要戴用elastics(橡皮筋),因為可能會造成molar
extrusion    (大臼齒挺出)

●遠心移動棒何時移除?→當病人看到上3/3剛好咬在下4-3/3-4間(必須是正常咬合) ,這就是可以移去的時候了

●CL  II   橡皮筋的建議(recommendations)~~~有配戴的病患請注意點閱!!

       strength(力度)    6  1/2 ounce(oz),  1/4 "(英吋)    tomy  H6或同級橡皮筋

       wearing time(戴用時間):

       a)low angle(低角): 24h/except eating  time(整天戴用除了進食時間)

       b)high angle(高角):night time (只在夜間使用)  ,if possible  14 h /including part of daytime(若是可以的話,全日戴用約14小時左右)

       the clinical efficency of the distalizer is only related to the amount of CL II

        elastic  traction(遠心移動棒的療效好壞與否,端視CL II 橡皮筋的牽引)

       the clinician must select the type of anchorage according to the facial pattern

      
profile (醫生必須針對病人的顏面形態來選擇支抗的形式)

       no necessary to take care of 3rd molars(遠心移動棒不需考慮3rd molar)

●distalizer的黏法,,在3/3,黏在牙齒中軸靠近近心1-2mm(利用其犬齒的設計弧度),molar則

        是牙齒的中軸線上,有一種情況就是犬齒高位或是轉位嚴重,此時遠心移動棒不易黏著,可以先由7654/4567兩邊先固定黏著,下顎的6-6的舌側還是以lingual arch 來做holding anchorage,再加上7/7若是可以上band就上,若是牙冠高度不夠好則以buccal tube 來bonding上,做CL
II elastics的牽引之用,,,,這是DR. CARRIERE的建議,,,,, 

unilateral application of the carriere distalizer

先前po過的凱利遠心移動棒相關文章(請點閱參考)

Carriere Ortho 3D(in iPhone)

Class II Correction:Esthetic Treatment options

Carriere Distalizer Carriere SLB Black Diamond Thermal
Archwires

Using the Carrière Distalizer for an improved Class I platform

Carriere Distalizer Brochure  

Primary indications
The Carrière Distalizer is ideal for treating growing patients and effective for treating adults. Clinicians can usually expect the same amount of
distalization and molar rotation in adults as children, although, as one would expect, treatment time for adults will be longer. On average, adult distalization takes 5 months; growing children, 3 months.

Brachyfacial
patterns respond best to this treatment followed by mesofacial
patterns; dolichofacial types are
less responsive. The Carrière Distalizer is indicated in the following types of
cases if deemed to warrant nonextraction therapy:

•    Class II malocclusions, both division
1 and division 2, symmetrical or asymmetrical
•    Class I and pseudo Class I
cases with mesially positioned maxillary molars
•    Class II mixed dentition
and adult  cases with maxillarydentoalveolar protrusion
•    Phase I
treatment of mixed dentition Class II cases with fully erupted maxillary first
molars. In this case, deciduous cuspids must be in good position to hold the
anterior segment of the appliance.

Secondary
indications
The Carrière Distalizer can be used creatively in
the treatment of:

•    Class I and Class II cases in which
four extractions would seem necessary. In such cases, the number of extractions
can often be minimized and a more esthetic facial result achieved
•  
 Unilateral Class II cases
•    Space recovery for retained maxillary cuspids
in Class II cases, unilateral and bilateral
•    Dentoalveolar Class III
cases using the Distalizer in the lower arch
•    Cases already treated with
four extractions that did not achieve a perfect Class I occlusion due to a loss
of anchorage. In those cases, the Distalizer can be used to achieve a solid
posterior class I platform.

Orthodontic Morphing from flaggada on Vimeo.