Today, hosts Dr. Leon Klempner and Amy Epstein are joined by the esteemed Dr. Luis Carriere, member of the Editorial Review Board for the American Journal of Orthodontics and Dentofacial Orthopedics (AJODO) and contributing editor of the Journal of Clinical Orthodontics (JCO). Dr. Carriere will share his expertise on improving patient and parent communication, particularly with young patients, to foster a sense of responsibility in their orthodontic journey. This approach boosts compliance and eases anxiety, transforming the patient experience. Plus, we'll dive into the mechanics and advantages of the motion appliance, including its role in dental alveolar movement and its long-term impact on growth. Get ready to explore practical tips, insights on the latest orthodontic tools, and a vision of future innovations—because there has never been a better time to be an orthodontist.
IN THIS EPISODE:
(2:50) Dr. Luis Carriere explains his approach to talking to young patients about their orthodontic journey
(10:23) The importance of treatment plans that engage young patients and improve their cooperation
(18:03) How to attract other patients to your practice by communication
(22:31) A deep dive into the motion appliance: its function and focus on dental alveolar changes rather than skeletal modification
(33:19) Dr. Carriere shares his insights on the future innovations
KEY TAKEAWAYS:
Encourage young patients to take responsibility for their orthodontic treatment by treating them as young adults. Understanding the "why" behind their role enhances cooperation
Educational tools and proactive communication build trust and establish credibility with patients and families, making your practice a trusted authority
The motion appliance primarily works through dental alveolar movements, creating a stable environment for growth in the correct sagittal and anterior direction, thus promoting long-term effectiveness
EPISODE TRANSCRIPT
What follows is an AI-generated transcript. The transcript may contain errors and is not a substitute for watching the video.
Dr. Leon Klempner: (00:00:00) Interested in learning more details about the motion appliance? Want to know, uh, how Dr. Carrier feels about whether it's skeletal or adenoalveolar? Want to know how to get cooperation with patients that aren't wearing elastics? Stay tuned. Our Golden Age of Orthodontics podcast sponsors make it possible for us to bring you new episodes.
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Narrator: The future of orthodontics is evolving and changing every day. But (00:01:00) although the way to achieve practice growth has changed, there's never been a better time to be an orthodontist. Let's get into the minds of industry leaders, forward thinking orthodontists, and technology insiders to learn how they see the future of the orthodontic specialty.
How will digital orthodontics, artificial intelligence, clear aligner therapy, remote monitoring, in house printing, and more. And other innovations change the way you practice. Join your host, Dr. Leon Klempner and Amy Epstein each month as they bring you insights, tips, and guest interviews focused on helping you capitalize on the opportunities for practice growth.
And now welcome to the Golden Age of Orthodontics with the co-founders of people and practice, Dr. Leon Klempner and Amy Epstein.
Dr. Leon Klempner: Welcome to the Golden Age of Orthodontics. I'm Leon Klempner, retired board certified orthodontist. Director of orthodontics, Mount Sinai hospital, part time faculty at Harvard.
And of course the CEO of people in practice. And as (00:02:00) usual, I'm joined by my partner and my daughter. Amy Epstein,
Amy Epstein: hello, good to see everyone happy to be here. I'm Amy Epstein. I have 20 years of marketing and public relations experience working with large brands and brand development, logo development, brand identity, development, public relations, um, and then bringing all that in partnership with my dad to orthodontist so that they can better position them in the markets that themselves in the markets that they serve to be able to, Articulate what makes them different from other practitioners in their area, why patients should come to see them.
That's what really we do at people in practice. So I'm thrilled to be here today to share some of that with you and also talk a little bit about our guests today. We're thrilled to have Dr. Louis Carriere, Who, if you don't know him, I don't know if there are a lot of people who don't know him, but he obtained his (00:03:00) dental degree from the University of Complutense in Madrid in 1991.
He then attended the University of Barcelona, where he completed his orthodontic training and received his Master of Science. In orthodontics in 1994 and then his doctorate in orthodontics cum laude from the University of Barcelona. Dr. Carrier was the winner of the Joseph E. Johnson Award in 1995 and the International Design Award Delta Gold for the Carrier Distallizer, which I think many of our listeners have used.
He's a member of the editorial review board for the AJODEO and a contributing editor to the JCO. JCO. Before I talk about him, you know, there's some more about Dr. Carrier, um, you know, we, we mentioned him, my dad and me a little bit in, in conversation because I was expressing that my daughter, who's my So, um, yeah, You know, your granddaughter, dad, (00:04:00) um, has, you know, talking about concerns with seeing the orthodontist for the first time and perhaps needing to have braces or, you know, early treatment because, um, she's almost got her, all her adult teeth in and this actually yesterday she was talking to me, does it hurt?
Does it this, does it that? And, you know, most of the time I say, Talk to grandpa and he'll have a look and tell you when it's time or, or whether it's going to hurt. But, you know, what part of what we'll talk about with Dr. Carrier today, I think is, you know, how to communicate to parents and, and, uh, patients themselves when they're children about how they can participate in their own orthodontic journey and how that changes compliance and, uh, changes anxiety levels and all of that.
Um, so dad, she's going to be. Peppering you with some questions the next time you're here. I'm just warning you. She's
Dr. Leon Klempner: no, I, I get it. Her name is Maya and she's a (00:05:00) handful and clinically, uh, you know, I used a lot of motion appliances in my career, uh, successfully, and I think she'd be a good candidate. Uh, my reservation about her, um, would be, uh, one that's similar that I, I spoke with, uh, Louise earlier about.
Uh, reaching out to some of the Facebook, uh, groups before getting on this podcast to get some input from the community in terms of. Any concerns or, or anything they'd like me to talk about. And one of the topics had to do with cooperation and, you know, while Maya is, we would expect her to be compliant.
Uh, a lot of kids sometimes are not. And that is an issue, um, with the motion appliance, because if they don't wear the rubber bands, nothing happens. So my first question, clinical question, would be, uh, Luis, So what do you do when you are dealing with a patient (00:06:00) that is just not, uh, fully compliant with the elastics?
Luis Carriere DDS. MSD. PhD.: First of all, uh, Leon, uh, Amy, it's a pleasure. It's an absolute pleasure to be in your podcast. I have been following you many years. You were doing a great, great, uh, interviews with Oscar podcast. So I have been very much entertained and learning a lot on many, many, many interviews that you have done in the past and a waiting.
Also for the new ones to come, for the new ones to come as the pearl of the, of enjoying the moment when, when they, when they come up, you know, so thank you for all this work. Thank you very much. Now, I know that you are facing a big issue because you are going to be, uh, By bombard, uh, by, uh, many questions about (00:07:00) your grandson, eh, and, and this is very important that, uh, that we, we give a good, uh, a good solution for, for, for your grandson and your for your son.
I mean, uh, and class two Occlusion is a patient that your son or daughter.
Amy Epstein: Exactly. Maya,
Luis Carriere DDS. MSD. PhD.: Maya. Sorry about that. So, but, uh, your daughter is, uh, uh, that these class two, uh, normally, uh, what I talk when I talk with them, when I talk with them and I go one after the other, and then I will. Focus on the, on the, on the cooperation.
But, uh, first talking about, uh, a little bit, uh, what we talk about, know the orthodontist, uh, with the kids. Uh, first thing, uh, the orthodontic treatment is the first responsibility that they are going to have as, uh, novel person in their life. (00:08:00) Uh, it's the first time where. Uh, they are declassified from a baby or from a kid into a small gentleman or small lady in which we believe that they will do the best job because it's the new responsibility of the world of the adult people.
So they understand and they want to be a part of it. This is very important. And secondly, uh, we, I like to talk about the importance and if you want, we can later, uh, brainstorm a little bit deeper on that, but a brainstorm about the importance of the orthodontics in life, uh, Why? Because I always tell them, you look, you now, you are a kid, you are a baby, you are a girl, you are a boy and you look very fancy with your tooth coming out here in front and it's fun and you look so cute and very nice.
But when you pierce (00:09:00) mustache and when, or when your face is becoming of a lady instead of a kid, then. This is going to be, instead of cute, it's going to be comic, and then it's not a problem, it's a problem. So you don't want to arrive there into with this scenario. So we need to solve that. The best moment to solve it is now.
In this moment of life that everything will be much easier, but we need, we need, We will give you a treatment that will be very small, very simple, very minimalistic, but has only one element that needs cooperation, like a car that is a beautiful car needs gasoline. To be working, this is an authentic appliance that needs its gasoline to work, which means that it's the last.
And where here is where it comes, where it comes, (00:10:00) this responsibility of being adult enough to be a part of the declassified as a baby and reclassified As a junior senior, so a junior adult, whatever, then they like to be involved. That secondly, uh, orthodontics is a profession that in the past was, uh, something that where the patient was.
absorbing the information of the orthodontist, and the patient was not supposed to ask many questions. But today, uh, we change. The patients are used to answers. Answers in their telephones, answers in their, uh, everywhere. So they need to have information. So, I think the era (00:11:00) of having patients just accepting the prescription of the orthodontist without having any kind of Comment or question or too many questions, uh, is not, is not correct.
Now, we need to explain properly and explain properly what we need, which is the treatment action, which is, what is what we expect. to accomplish, the timings in which we pretend to accomplish and the targets and the steps to follow to the end. So once we explain everything properly to a young kid, it's super easy to have their cooperation.
And what is very difficult to have cooperation is when we just say, Put the elastics. Okay, an order. (00:12:00) No explanations behind. You put the elastics. Then, don't expect anything from your patients because they don't understand what is your target. They don't understand which will be the effect. They don't understand how long it's going to take.
They don't understand which will be the benefit for them. They don't understand anything. So well, they will never comply with you. So I think that argumentation, that good communication with the patient, the parents, the doctors, are spectators of the conversation, but the one is the patient. So, uh, again, instead of talking with the parents, we have to focus on the patient as a small adult that we are giving them the, Hey, here is the trophy of the being for the first time in your life and a small adult.(00:13:00)
Dr. Leon Klempner: Yeah, it makes a whole lot of sense. And, uh, you know, and I understand the frustration that many of my colleagues have about Uh, treating with appliances that require a cooperation because it depending on, you know, the communication styles and the skill sets of the orthodontist, they may not have, you know, uh, as compassionate a, a communication approaches you do, Luis, for example, you know, in my experience, it doesn't have to be the orthodontist that does the explanation.
If you have somebody in the, in the office, that's a good communicator. That is warm and, and, and playful sometimes and could relate to children. Then that oftentimes is, is a good way to the cooperation rather than, uh, trying to be something that you're not with a 10 year old, have somebody else just, just prescribe it (00:14:00) and then pass it along.
So that that's worked well for me and I'm pretty good communicator, but there was some kids I just wasn't getting through to, but. Somebody on my staff was able to get through. I've also found, and I'm curious, uh, uh, uh, your opinion, Luis, is that the younger patients are much more compliant than the older patients.
Uh, the young ones tend to want to please, you know, so for Maya, for example, I think she'll want to make the orthodontist happy. Um, I think that, you know, that, that, you know, in her instance and in other, other kids, typically, I did a lot of early treatment in my practice. Those kids typically, you know, want to go on the ride with you if you make it playful and make sure it doesn't hurt, obviously, uh, they'll, they'll, they'll go with you.
So, um, I appreciate the, uh, the insight, but let me, let me just follow it up with another clinical question. Cause I, I can hear. I can hear the rumbling in the orthodontic Facebook (00:15:00) groups. Uh, um, so, so what do you do when you can't get cooperation? I mean, there's gotta be some that, that, that it just isn't going to go.
What's your go to appliance or what do you do next?
Luis Carriere DDS. MSD. PhD.: Yeah, normally, uh, I am, uh, very persuasive. What this means, what this means that, uh, I might, They just take more time, but they keep, they end up cooperating. Uh, I have been, I have had patients over one year with emotion without cooperation. And then suddenly they click and they They kill it in three months.
So, uh, it's a matter of explaining. And I tell you that probably I have, I had few, uh, few failures on the cooperation, but those failures, all of them, That I can (00:16:00) count probably in less than, uh, than, than, than one, one hand, uh, are sons of friends that they didn't pay for the trip, but this is another subject that is very interesting, uh, because they don't take you in serious and this and that.
So I removed the appliance and I said, Hey, you know what? We will take in another moment when you are ready, we are going to, uh, treat you in, in, in the future. Okay? So this has been the story of this appliance. At the end, it's an appliance that has been simplified so much the, uh, the, the treatment. And I, uh, uh, I look forward, uh, having, uh, long term stability results, but I never will go, for instance, for extractions in cases that, that, uh, I, I, I wanted to solve it, uh, without the (00:17:00) need of, uh, removing to upper bicuspids, and then I ended up removing to upper bicuspids because then what you do is to reduce volumetrically The three dimensions, the maxilla, and this is affecting negatively on the final profile of the patient.
So, uh, this, I prefer to stop and, and, and, and, and go back.
Dr. Leon Klempner: Okay. Understood.
Amy Epstein: It sounds like you have, uh, you know, you take a particularly communicative approach at your practice, right? And, uh, and, and not everybody does that. And, um, you know, in your, you practice in, in, uh, outside or in Barcelona. Right. And so, um, are there ways that you, uh, leverage your communication style and the partnership that you have with patients and, um, the efficacy that you have with patients because of your communication in order to attract other (00:18:00) families?
Um, to the practice,
Luis Carriere DDS. MSD. PhD.: you know, Amy, uh, one of the things that I use, I have done many videos, uh, and animations of the treatments from the beginning to the end, step by step. And they are super useful to show them to the patient, to show them to the, uh, to the parents for both, uh, for the first appointment and after.
Also, I send them by, uh, airdrop or by, uh, any other way for, uh, by WhatsApp or whatever the, what they use, I send them to their phones in order to have, they have the treatment protocol and explain very clearly the steps that we are going to follow. And this is very important. Uh, I have seen that talking and explaining save a lot of time to the orthodontist.
Instead of we might think, oh, I (00:19:00) cannot lose my time, uh, because I, you know, I'm super busy. I cannot talk that much. Well, this saves time. Is make you spend lots of hours of chair time that if you have been just talking for 10 minutes in advance, explaining your intentions, spending your protocol, spending all the steps you want to follow, everything would have been so much easier.
And this has been my experience at this point.
Amy Epstein: Yeah. Yeah. The educational tools that to the patient and the parents and the practice, I think that that's, uh, those are underutilized tools, communication tools, um, by orthodontists. We often will see that they're with proactive communication tools. We'll often see, um, you know, uh, This sort of education when there is a more acute change, let's say happening in the (00:20:00) practice is a doctor coming in and we want to communicate to everybody about this new associate or doctor is retiring or opening up a new office, these sort of transitional, but it's all about communication and education.
When it comes down to it, and even when we help our practices advertise to communities to bring in more patients, it's all about education and communication. Because when you explain things, that's when the people understand that they have fewer questions. They're made more comfortable. They, they can see you as someone who is an authority on what you're talking about in all of that lens credibility.
Uh, and authenticity to your practice and makes people want to come to see you.
Luis Carriere DDS. MSD. PhD.: Absolutely. Amy, you're coming from the marketing and communication is all about sending the message. Do you imagine sending a message without communication?
Amy Epstein: Yep. Not possible. So it's, uh, it seems like we're very aligned in the, in the approach that, (00:21:00) um, you know, in the way that you engage your patients and, uh, and that's probably why you have so much compliance.
Luis Carriere DDS. MSD. PhD.: Well, it's trying to make my life easier and brainstorm what I would like as a patient, and that's it.
Dr. Leon Klempner: So, Luis, I am interested in your views of aligners and some of the appliances that you're using in your own practice in conjunction with the motion appliance. But I want to just circle back into another issue that I see coming up from.
Colleagues of mine, which is a discussion regarding the mechanism of how the motion appliance actually works. So, you know, my understanding is that, you know, there's the rotation of the molars. Uh, there's a distal force is a music component with class 2 elastics. But, you know, there are a lot of colleagues that are questioning whether, um, uh, The position of (00:22:00) Henry Schein as they're promoting this, uh, uh, has to do with whether we're dealing with a skeletal problem.
Are we, are we treating a skeletal problem or, or is the correction primarily dental alveolar? So I wonder if you could just clear it up for the audience, cause I know that, that it comes up and, and I haven't really seen a lot of advertising that, that, uh, promotes skeletal changes with, with the motion appliance, but maybe you have a different view.
Luis Carriere DDS. MSD. PhD.: Yes. Thank you. This is a very nice question. Very good question. And how the motion works. Okay. The motion appliance is an appliance that, uh, intends to generate and move groups of teeth from canines, premolars and molars from class two into class one and from class three into class one, converting at the beginning of the treatment, the class two into a class one or the class three into a (00:23:00) class one, uh, from in the posterior segments of canines, premolars and molars.
Okay. So, uh, by, uh, the motion appliance, um, when I conceptualize motion appliance, I was very much, uh, deeply studying long term stability. Long term stability, and which was the key for having a good occlusion of molars, uh, for the years to come and having, uh, the canines and pre molar occlusion for the, for many years in class one.
And the important thing was that rotation of the, to the distal one. was one of the most important things by Stoller. Arnold Stoller did a beautiful article in 1956 at the American Journal of Orthodontics in which he explained very well that rotation of the molars and uprighting of the molars was (00:24:00) necessary to accomplish adequate occlusion of the Uh, of our teeth for the long term stability.
Okay? So, uh, what I did is to go to the Mother Nature and imitate what Mother Nature, what was, had created. What I did is to imitate the coxofemoral joint. The coxofemoral joint that was with this. Uh, ball and socket to rotate and upright. I needed to upright because Moller's, uh, Henry did a beautiful article studying thousands of malocclusions, and he saw in 1954 in American Journal of Orthodontics, and he saw that, uh, The 83 percent of our malocclusions, they have excessively majorly inclined molars, majorly inclined molars, and majorly rotated molars.
So what we needed is to upright those molars and rotate them. So I did this head ball on the joint of the motion appliance and (00:25:00) flattened the poles and gave also tolerance to be bonded on this majorly inclined molars that the 83 malocclusions are suffering. Because if you end up in a malocclusion with your majorly inclined molar, this major inclination is pushing towards class two, towards, uh, uh, class two, all the premolars and canines, and you're losing your occlusion easily.
easily in a short run. So upwriting is super important. This is why I did the motion appliance side specific. Okay. So biomechanically speaking is, uh, is that motion appliance is to rotate the molars, upright the molars, move the posterior segments, uh, as a block to accomplish class one at the beginning of the drilling.
In class two and in class three. And this appliance is helping into accomplishing a solid and consistent equation. And what is, (00:26:00) uh, the motion appliance with the characteristic? It's side specific. Means there is a left and there is a right one. So by, by knowing this is today, there are some imitations, some copies of the motion, but they are universal.
Why is it universal? Why they did it universal? Because they don't know what is the thinking behind, what is the thinking behind, of biomechanics. When I conceptualize the motion and they just simplified by copying without, without knowing what was the biomechanicals behind, probably engineers. Now, what is this about?
What is this about? Is this an appliance that is functional? This is appliance that is Is a skeletal, is a dental, veolar. Well, this appliance is an appliance that normally the major amount of our malocclusions of class two, for instance, when we talk about class two and class three as well. (00:27:00) But if we talk about class two, for instance, um, the major amount of our malocclusions, they have.
An incorrect positioning of the disc. The disc is shifted forward. There is a beautiful article of a Swedish group, uh, that, uh, they studied MRIs of class 2s and class 3s, and they saw that the discs were shifted forward, and the condyle was back and up. So the motion of lines is changing the occlusal plane, changing the occlusal plane.
By changing the occlusal plane, helps into the distraction of the condyle from the deepest part of the fossa. And this distraction, this This, uh, distraction, this dislocation of this condom from the deepest part of the fossa helps into a spontaneous reposition of the disc and a spontaneous reposition of the mandible fold.
Okay? This is not a matter of growth, because if you look from the beginning to the end, the short treatment, the short treatment. of the motion appliance is normally the average of treatment is around (00:28:00) three months, four months maximum. If the patient cooperates, if you have issues of cooperation, then can be elongated.
Okay? So, uh, when you, uh, start with a retruded mandible, you accomplish an adequate position of the mandible, but this is not going to be growth. It's going to be a reestablishment of the function and the relation in between the maxilla And amazingly, this is going to be super stable because today, one of my, my courses is all about long term stability.
And when I say long term stability means 16 year follower of the malocclusions with retarded mandibles with adequate position of the mandible at the end. And. Uh, how it has been this kept along 16 years. So this is, uh, this is the, uh, the, the effect of this. Now, there is a lot of (00:29:00) evidence based on the use of the motion appliance.
And before you were telling me the, uh, about, I am pointing out a little bit on the different questions that you have been, uh, Placing because, um, going back and forth, but you were saying, well, some of my colleagues are concerned about these, these appliance. If these is going to do big cooperation. Well, this appliance is appliance that is the fastest appliance to accomplish the correction of the malocclusion.
And there is something in common of the overall, uh, Okay. Already hundreds of case of articles published on the motion appliance. Today, there is a little big evidence based behind published American Journal published in the angle journal angle, orthodontist at the J. C. O. and several other journals that has been published today and all of them.
They say that this is (00:30:00) an efficient appliance to accomplish the treatment in class 2, and this is an efficient appliance to accomplish the treatment in class 3. So, uh, this is the important thing that this is an appliance that if the patient operates, you can strongly promise the results to your patient.
Dr. Leon Klempner: So yeah, so just, just to wrap it up and just to be clear, where other than, Uh, some possible repositioning of the mandible if the, if it's retreated. Uh, other than that, we're primarily talking about dental alveolar changes, the teeth moving through the bone, um, in segments, we're not, uh, growing a mandible.
We're not, uh, preventing growth in a class three, uh, we're, we're primarily doing dental alveolar movements. Is that a fair assumption?
Luis Carriere DDS. MSD. PhD.: Yes. Uh, what we are doing is we are changing the crucial plane. This is making the distraction of the condyle. This is (00:31:00) raising the space for the disc. This is a repositioning the mandible forward.
This is locking everything in class one in this new anterior posterior relation of the mandible forward in relation to the maxilla. In the maxilla, and then the growth that is going to come is going to come in the adequate direction, will redirect the growth into the direction of this new stable scenario, sagittal and anterior position of the manual sagittal correction that is stable and this, the growth is going into this direction.
Okay, so, uh, this. What we are talking when we are seeing articles about mandible growth of herbs, appliances, or this, their growth is about millimeter, millimeter and a half, two millimeters, two millimeters. They don't make the difference in a mandible position. They don't make the difference. You cannot see two millimeters change.
in a mandible position. If (00:32:00) there is a change on this, on the relation between the maxilla, functional change, reposition of the condyle, then you will see the change beautifully in the mandible. If there is a change of the occlusal plane, this changes the width of horizon. There is a massive, uh, change of the aspect of the patient.
This is why we are giving an absolute nice alternative to surgery in class three cases. And this is something that I would like to brainstorm a little bit if we have time.
Dr. Leon Klempner: Well, we'll, we'll, we'll definitely have to schedule another podcast. Time goes by, uh, so quickly. Um, but Amy, I know you had something that you wanted to bring up.
Amy Epstein: I do. I, you know, I'm wondering, you know, we're talking, um, a lot of shop talk as my dad says. And I wanted to know if we could shift gears and look ahead a little bit. Um, and, you know, in partnership with. Henry Schein orthodontics. What are you working on? What (00:33:00) innovations are the hopper? And what can we look to expect?
We have the AIO coming up again in late April, I think this year. Um, we'll be giving some talks there and I am sure you are always doing lecture around the world. I'm sure you're going to be giving a talk there too. Tell us a little bit about what we can look to expect.
Luis Carriere DDS. MSD. PhD.: Yeah. Well now, uh, I think I am in a moment in which I am, uh, a little bit more creative.
Uh, there are moments in life, no. And, and, uh, now I'm, I'm working, uh, a lot on how to diminish the number of appointments. What do we call Minimal touch, orthodontic. And, uh, what we want is to, uh, make life easy for our patients. And, uh, this unit, an appliance. For like the motion, for instance, that helps you and you position it and you remove it.
Uh, when the everything settles in class one, this means that you only need (00:34:00) two appointments, the positioning and the, and the removing in the, in the mid in between you can monitorize in the distance for, for instance, using the green, uh, green, uh, technology or dental monitoring or whatever you use. No, uh, second, uh, then once you have the class, one of the posterior segments, you wanna go into the next stage that is the bracket.
Well, we have the carrier SX bracket that is a passive ultra, ultra, uh, uh, efficient in terms of, uh, uh, of rotation because is a full size slot covering with the sliding door and this, and with the three wire sequence. And this is giving us the possibility. The possibility of diminishing the number of appointments because we squeeze the capacity of the wires to accomplish.
In fact, in those cases of short treatment timing and that I'm not now focused, I try to go to the two wire sequence, (00:35:00) two wire sequence instead of three wire sequence. Okay, our wire sequence is three, but now I'm trying to go into the two wire sequence in order to diminish the number of appointments. Now.
Uh, it was something was ruining all the project of the minimum touch orthodontics. What was that? The elastic chain, the elastic chain that we place, uh, elastics to close, uh, uh, certain spaces in between incisors. And then suddenly you place the elastic chain and this chain is losing power and it gets dead.
And then you need to change it, change it, change it. It means several appointments to change an elastic chain because it is not closing as you expect because they it's suffering what it's called a creeping the generation of the properties because there is pressure, moisture and temperature. So I said, hey, we need to figure out something.
So I came up with an (00:36:00) idea of using memory of shape. So we have nighttime. We are lucky to have nighttime. So I designed an infinity loop, a loop, an infinity loop, that this loop was intended to substitute the elasticity of the chain. Supposed elasticity because software scripting, and instead of that, we were placing the infinity loop.
This infinity loop has a memory shape and closes the spaces in one step. Now this, this means that, uh, uh, it's, Completely, it's completely, um, uh, it's completely eliminating the number of appointments in between. And amazingly, as it has memory of shape, the appliance, once has the gaps or the spaces closed, gets totally passive because has the original form.
It's not stretched. So it's very interesting. And now it's, this is (00:37:00) called the carrier infinity loops. The next is that, uh, it's, uh, uh, night tie, night tie ligature, uh, which is also memory of shape in order to convert every traditional ligating bracket into a low friction bracket by the use of the night tie.
ligatures, substituting the elastic rings by elastic nightly ligatures. This is the next project. And then I have also, uh, that an appliance that this year also I am pleased I am coming with this innovation, but it's not, it was not going to be yet in the market, but it will be, I will be. Talking about that, this is a premier, uh, that is going to be, uh, cat, uh, temporary, temporary anchorage device, but how with (00:38:00) an active abutment and the abutment will be of night time.
So now the one doing the job. Obtraction will be the active abutment of the temporary anchorage device. Instead of having the anchorage device as a passive receiver of an elastic, elastic chain, that is going to be super, uh, um, uh, inefficient. Now we can just then reposition the tip. Of this, uh, temporary correct device and this will bank move everything, uh, with the memory of shape again.
Amy Epstein: Well, we look forward to seeing and learning more about that when we see you in April at the, uh, at the a a o. Thank you for talking about that with us and thanks for taking the time to talk with us today. We know you have a lot on your plate. You lecture globally and uh, you know. (00:39:00) Teach classes. And so we appreciate the time that you've spent with us today.
If our listeners would like to learn more or ask you a question or have a follow up, how might they be able to reach you?
Luis Carriere DDS. MSD. PhD.: Well, uh, well, there is a lot of information at career system. com career system. com and this is, uh, very much information and, uh, also in my website. Uh, at career you have more information.
And so basically, uh, around this, and Als also, there is, I tell you, uh, osteo, osteo, eh, there is a, uh, that they did a nice record of a course I did that. I'm very, very happy of it. That, uh, they did. And it's beautiful. It's, uh. Six hours, of course, and it's very interesting if (00:40:00) someone wants to look at it.
Amy Epstein: Okay.
That's very helpful. We'll go ahead and we'll share that link when we post this, um, podcast live. again for joining us today and we'd love to have you back and we look forward to seeing you soon.
Luis Carriere DDS. MSD. PhD.: Thanks. Thank you. It's a pleasure, an honor, and looking forward to your next, next podcasts that I'm thirsty of it, of them.
Amy Epstein: We're glad to hear it. And you know, for, for you and for all of our listeners that enjoy this episode and are also looking forward to other episodes, you can download them or subscribe to the golden age of orthodontics on Apple podcasts, on Spotify. SoundCloud, YouTube, or wherever you get your podcasts.
And if you enjoyed it, we appreciate that everyone should share it with a colleague for more information about people in practice, which is the marketing consultancy that my dad and I co founded (00:41:00) about 15 years ago. You can sign up, uh, on our, you can look at our website and learn more about the business and contact us there.
And there's this little chat at the bottom. If you. Type in your, say a little message or whatever. It actually goes right over to my dad's cell phone and he'll, he'll write back to you there. I'll text you right back. So thanks everyone for watching and listening.
Dr. Leon Klempner: So, uh, someday I want to be as smooth as Luis in terms of, uh,
Amy Epstein: you have
Dr. Leon Klempner: communication.
I mean, I don't know how, I don't know how, uh, how you get any sleep. Do you, do you sleep at all? Yeah, I'll tell you
Luis Carriere DDS. MSD. PhD.: something. I am very bad sleeper. This is one of my issues. I
Dr. Leon Klempner: have long nights, very long ones. All right. Well, that's probably where the, uh, innovation and ingenuity comes into play. So, so I want to thank everybody for watching and listening.
Uh, of course you can contact me with any questions that you may have. Uh, my email address is Leon at PPL practice. (00:42:00) Uh, you can, uh, Direct message me on Facebook, on LinkedIn, you know, I'm all over the place. Um, uh, so remember that for forward thinking orthodontists, it really has never been a better time to be an orthodontist.
So, we are in the Golden Age, and we'd like you to take advantage of it. So until next time, see ya.
Narrator: Thank you for tuning in to the Golden Age of Orthodontics. Subscribe now on Apple Podcasts, Spotify, or visit our website at thegoldenageoforthodontics. com for direct links to both the audio and video versions of this episode.
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