L'' Orthodontie française最新文献

Different surgical and non-surgical techniques have been developed in order to reduce the duration of orthodontic treatment. Regarding surgical techniques, corticotomies are widely used. The micro-osteoperforation technique (MOP), in addition to the piezocision technique, have been developed to provide minimally invasive surgery as an alternative to conventional corticotomies, without the elevation of a mucoperiosteal flap. Regarding non-surgical techniques, the approach is radically different in terms of physical stimuli or chemical techniques. Corticotomy and piezocision techniques have been found to be effective in accelerating orthodontic tooth movement, although the corticotomy technique presents a significant risk of postoperative treatment. These two techniques also offer the possibility of adding a bone graft using a tunneling surgical approach. Regarding non-surgical techniques, physical stimuli techniques such as with a laser are easy to perform, non-invasive and seem to be promising. However, their effectiveness has not yet been demonstrated, as is the case for chemical techniques. While at first glance these techniques are reassuringly non-invasive, do they not give the sensation of playing the sorcerer's apprentice ? Although surgical techniques seem to have demonstrated their significant efficacy in accelerating orthodontic tooth movement, non-surgical techniques do not yet provide a sufficient level of evidence and / or safety to be performed in our routine clinical practice as orthodontists. As these topics are innovative, new and future scientific evidence should be able to lead to the development of all these concepts.

The aesthetic and functional success of mandibular advancement surgery often depends on the quality of the orthodontic preparation that preceded it. In order to be optimal, this preparation must try to reproduce a class II malocclusion equivalent to the sagittal skeletal discrepancy, to allow a surgical procedure of sufficient amplitude. The aim of this article is to present, thanks to a clinical case, a new mandibular posterior anchorage device, called Abalakov, used in the context of these preparations. The modalities of placement and use of this simple osteosynthesis wire, placed in the anterior part of the ramus, are exposed step by step, until the final result is obtained. The advantages and effectiveness of the technique are then discussed and compared with other treatment alternatives. It can be concluded that this new device is a simple, comfortable, inexpensive and above all reproducible and highly effective means of distalization of the mandibular arch, with clear uprighting of the incisors.

As it is the case in the medical sector, Google reviews of orthodontic practices are on the rise. The main objective of the study was to describe the internet ratings and opinions on orthodontic practices in France. The second objective was to test the factors that influence the number of reviews and the overall rating. We conducted a descriptive study on Google reviews, on 700 specialists in orthodontics in mainland France. 87% of offices got at least one review on Google. An office receives an average of 9.6 comments; 63.6% of reviews are associated with comments; 10.8% of opinions receive a response from practitioners. The average number of stars is 4.1 (+/- 0.7) out of 5. Four types of comments are significant in the context of a multivariate analysis: monetary considerations, the level of hygiene felt, temporal parameters (punctuality…) and the setting of the office. Opinions regarding therapeutic assessments, even though they are the most frequent, only concern 40% of the comments. The socio-economic level of the city, the population density and the concentration of practices are not explanatory factors for the number of reviews or the average rating. A comment related to punctuality or fees lowers the grade. Opinions are given spontaneously and do not necessarily reflect patient satisfaction. A comparative study of the patient actual satisfaction with the average rating on Google could be interesting.

The aim of this systematic review and meta-analysis was to compare self-ligating brackets (SLBs) considered as a whole to conventional brackets (CBs). An electronic search was performed in three databases (PubMed, MEDLINE via Web of Science, Cochrane Library) from their origin up to June 2017. Additional articles were hand searched from January 2006 to June 2017. This meta-analysis was restricted to randomized controlled trials (RCTs) and split mouth design studies (SMDs). No distinction was made between active and passive SLBs. The following variables were investigated : treatment duration, number of visits, alignment rate, rate of space closure, perception of discomfort during the initial phase of treatment, pain experience during wire insertion or removal, bond failure rate, time to ligate in or to untie an archwire, periodontal indices, occlusal outcomes, transverse arch dimensional changes and root resorption. 25 RCTs and 9 SMDs were finally selected. It was more painful to insert or remove a 0.019× 0.025 SS archwire in/from SLBs. It was significantly quicker to insert or remove an archwire from SLBs. There was less bleeding on probing with SLBs 4 or 5 weeks after bonding. All other variables did not exhibit any significant difference between SLBs and CBs. Out of the 31 comparisons between self-ligating and conventional brackets, 9 only revealed statistically significant differences. This meta-analysis contradicts most of the promotional statements put forward by the distributors.

For Helm, "the rhythm of facial growth often governs the course of orthodontic treatment". The moment of treatment is an important dimension for our therapy to last a minimum of time with a greatest chance of success and stability. This notion of processing time is a daily requirement in our practices. The radiographs of the wrists will gradually disappear according to the ALARA principle, since we can in a single irradiation, via the profile radiography, have sufficient information to situate the patient on its growth curve. The vertebral stages are good biological indicators of individual skeletal maturity but their interpretation remains difficult. In this work, a computerized method was used to determine the stage of vertebral maturation in a reliable and reproducible manner. In this study, 15 young boys and 15 young girls (total 30 patients) were included, 12,2 years old on average with a standard deviation of 2,6 years. To determine the skeletal age of these patients, the practitioner made an hand-wrist x-ray and, for diagnostic reasons, he also made a profile radiography the same day. The patients who didn't made an hand-wrist x-ray were excluded. The vertebral computerized method seems to be a reliable method to be used in orthodontic practices. Other studies would allow to use this method for average ages, gender-appropriate.

According to several theories, the oro-facial sphere would be interconnected with the rest of the body justifying the requests for care to improve a body zone at a distance. The aim of this literature review was to look for potential distant links of dysmorphoses of the three dimensions of space according to the etiopathogenic theories and the data of science. We carried out a keyword search leading to 58 references. In the transverse dimension, the transverse maxillary hypoplasia and dissymmetry of the molar class of the transverse dimension would not induce a change in the distribution of the weight of the body on a stabilometric platform. In the vertical dimension, hyperdivergent patients have a decreased bite force, cephalic extension with respect to the spine, an extension of the base of the skull, and decreased cervical lordosis. In the anteroposterior dimension, skeletal classes II would be associated with increased cervical lordosis and posterior cephalic extension according to the « true vertical » (inversely for classes III). The prevalence of dental classes II would be increased in scoliosis subjects. Studies with a low level of evidence (grade III, IV or even V) should be interpreted with caution because the simultaneous presence of concomitant anomalies does not allow us to conclude that there is a cause-and-effect relationship.

The first publication on the use of magnets in dentistry for stabilizing prosthetics on implants dates back to 1953. Clinical development in orthodontics, without having experienced a real boom, has increased over the past ten years, in parallel with the improvement of the device. The objective of this review of the literature is to synthesize clinical applications and reported iatrogenic effects. A systematic review of the international literature from the Pubmed and Cochrane databases from 1999 to July 2018 was conducted which resulted in 36 articles. The factors studied are the indications and contraindications, the means or procedure, as well as the iatrogenic effects. Original cases are presented. The correction of infraclusions is the main indication, followed by the correction of anteroposterior malocclusions and then the correction of over-erupted teeth. Traction of an impacted teeth and diastema closure have not been found in recent publications probably because of the low benefit-risk ratio. The future no longer seems to be buried magnets or left in the long term in the mouth considering there seems to be concerns in terms of toxicity (or even the risk in terms of vital prognosis). The magnets could offer interesting perspectives to manage the current limits of the aligners, the movements of anterior egression, rotation and previous torque being still problematic...

Obstructive Sleep Apnea (OSA) in children, which has a multifactorial origin, can lead, if not treated, to severe medical complications, growth disturbances, behavioural changes and reduced quality of life. Nowadays, it is underdiagnosed whereas early screening, diagnosis and interdisciplinary treatment are essential. Furthermore, many families and health professionals do not often know where to go when there is suspicion of OSA for a child. Orthodontists are uniquely positioned to screen, to refer to the appropriate specialist and to treat, if needed, patients who may be at high risk for OSA. The authors describe the synergistic means to screen, diagnose and treat paediatric OSA in a collaborative and interactive approach between ENT, orthodontists, pneumo-allergologists, sleep physicians, endocrinologists, orofacial myo-functional therapists and speech therapists. These means which are clinically illustrated in this paper fit the guidelines which have been recently published as white papers by official professional specialists organisations involved in paediatric OSA treatment (AAPD, AAO, FFO, SFORL, SFRMS…). The development of multidisciplinary teams gathering specialists who are conscious about the mutual benefits of the specialties involved in paediatric OSA should contribute to optimize the child treatment care pathway and the short, mid and long term outcomes.

Studies about orthodontic relapse have always confirmed the occurrence of some occlusal changes after orthodontic treatment. The reopening of premolar extraction spaces is one of the most frequently observed movements and would have several origins : gingival folds, root proximities, muscular imbalance... and particularly unstable end of treatment occlusion. The aim of this systematic review was to study the correlation between quality of the occlusal finishing after orthodontic treatment with premolars extraction and reopening of extraction spaces. The review was undertaken according to PRISMA recommendations from the Cochrane Handbook through an electronic consultation of the PubMed database to identify clinical trials that responded to the PICO research question. Five studies met all the inclusion criteria. Three studies used the Peer Assessment Rating (PAR) in assessing the quality of the occlusal finishing. For two of these studies, there is a correlation between poor occlusal finishing and reopening of extraction space. For the other three studies, no cause-and-effect relationship between these two factors has been proven. The divergence of the published results was explained by the fact that the stability of an orthodontic treatment depends on multiple parameters. Further controlled clinical studies should be conducted to objectively evaluate, without interfering with other parameters, the role of occlusal finishing in the long-term stability of orthodontic treatment.