Pacific Coast Society of Orthodontists Bulletin Winter 2023 - 39

Let's Talk About That
Figure 1. In Independent Movers, teeth are connected
to an anchorage base, through custom NiTi arms. The
design of each arm is such that it applies the optimal
force and moment to the tooth to move it from its
initial position to its final ideal place, almost independent
of other teeth. Complicated computational analysis
will determine the design and thickness of that
particular arm to apply the best force and moment
Independent Movers have several advantages. For
example, Independent Movers are on autopilot, so
no adjustments are needed, so seeing those patients
frequently, as with braces patients, is not necessary.
Independent Movers could be placed on the lingual
side, which helps with the esthetics of the patient.
The esthetics of Independent Movers is superior
compared with aligners since they are truly not visible,
whereas aligners and attachments are visible if you
get close to the patient. The other advantage is that
teeth can move independently of each other, which
has deep biomechanical implications. Imagine you
are moving a high buccal canine. In this scenario, if we
use an NiTi wire in braces, when we move the canine
occlusally, the lateral and premolar next to it will most
probably move in the wrong direction and apically.
Independent Movers will solve this problem since
the reaction force of the canine will be applied to the
anchorage base, which will distribute the force and
moments on all the teeth and not only on two adjacent
teeth. This decreases the negative side effects
on the adjacent teeth significantly compared with
braces. The other advantage of Independent Movers
is that they are fixed, so compliance as compared with
aligners is not needed.
Figure 2. After bonding the brackets to the teeth with
the bonding tray, each arm is engaged to the bracket.
Brackets act like handles on the teeth and each arm
grabs the tooth and moves it from its initial position
to the final ideal position. The type of bracket does
not matter in the concept of independent movers
and theoretically, any bracket including twin bracket,
self-ligating bracket, or any other bracket can be used
as the handle on the tooth
PT: How is the appliance delivered and activated?
MP: The workflow to use Independent Movers is
simple. You need to submit the scans of the teeth
to the Brius platform called Brius Planner and give
instructions on what you want the final position of
the teeth to look like. Ideally, if you submit cone-beam
computed tomography (CBCT), then that will help
to have a better result and better treatment plan,
but CBCTs are optional. After you approve the virtual
treatment plan, the device itself and the digital bonding
tray (DBT), which has the custom brackets loaded
to it, will be shipped to you. After preparing the
surface of the teeth in the normal way you prepare for
bonding brackets, the DBTs will be used to bond the
brackets precisely. The next step is to engage the arms
of the Brius to the teeth one by one (Figure 2). In the
following visits, you need only to observe and make
sure all the arms are engaged and that no bracket has
debonded. In case of debonds, you can cut the DBT
for that specific tooth and make a jig. That way, you
can rebond the bracket with high precision. In the
same way, patients can easily floss with Independent
Movers; there is no wire connecting the teeth, and
the orthodontist can easily do interproximal reduction
without removing the device, which will save chair
time.
Winter 2023 PCSO Bulletin
39
Pacific Coast Society of Orthodontists Bulletin Winter 2023

Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Winter 2023
