We have earlier discussed techniques to move back molars. The Spanish doctor Luis Carriere invented a prefabricated molar distalizer that can be used in the permanent dentition to move back a quadrant from cuspid or first premolar all the way back to the molars. An ideal situation would be a case needing no more than 4mm of molar distal movement, about half a bicuspid. If you push the appliance to the extreme you will probably get more side effects like molar tipback and cuspid extrusion. If this happens you will need more advanced mechanics to manage the case. A patient may present in which you decide to move back the molars to regain a Cl I or make more space for the cuspids. The Carriere appliance has many advantages: it is very small, it will not impinge on speech, it can be used right at the start of treatment without a full strapup. The force needed to move back the molars comes from Cl II elastics anchored to the lower arch that can be either in full strapup or only in an overlay acrylic splint with windows on the molars to receive a lingual arch and a buccal bonded button to attach the Cl II elastics.
Dr. Michel Champagne dmd, magd, ibo, cde