L'' Orthodontie française最新文献

Introduction: Orthodontic diagnosis is generally centered on the morphological aspect, as is the treatment: it is most often a matter of modifying the shape of the arches and their relationships to adjust them to a morphological norm with the goal of a beautiful smile. However legitimate it may be, this diagnostic approach may seem reductive if we consider that teeth are also used to chew: it is even their main function. But how to take into account the masticatory function?

Materials and methods: With the help of clinical examples, the author develops the modalities of the clinical exploration of the mandibular kinematics, reflection of the mastication, on which the systemic diagnosis is based. It highlights the proprioceptive resources of the masticatory system that systemic treatment targets during the correction of malocclusions.

Conclusion: The systemic diagnosis highlights the functional role of the arches, inviting, during their correction, to rehabilitate mastication in order to improve their stability.

Introduction: The aim of this article was to present a synthesis of recent bibliographic data concerning the relationship between orthognathic surgery and temporomandibular disorders (TMD). Materials et Methods: A search of relevant articles published over the past ten years (2010-2020) was performed in PubMed using the keywords « orthognathic surgery » and « temporomandibular disorders »: 31 articles were included in the review. The data were classified in three main chapters: (1) the effects of orthognathic surgery on TMD, (2) the consequences of orthognathic surgery on the condylar position and (3) the musculo-articular complications of the orthognathic surgery.

Results: The results of clinical studies show that the effects of orthognathic surgery on TMD are variable and difficult to predict, so that orthognathic surgery cannot be considered a reliable therapy for joint dysfunctions.

Discussion: This review also sheds light on new aspects emerging from recent publications, such as the influence of bruxism, oral dysfunctions and psychological factors and the problem of condyle positioning with the development of techniques for modeling the stresses exerted on the condyle by the finite element method.

Conclusion: The risk factors for articular complications are poorly known. Female gender, skeletal class II, hyperdivergent profile, rigid osteosynthesis are often reported, but the most factor is the significant preexistence of a joint dysfunction (discal displacement in particular), which argues in favor of a systematic articular pre-operative evaluation including MRI of the temporomandibular joint.

The premature detachment of orthodontic brackets has consequences for the patient and the practitioner. While the responsibility for the bonding protocol has been widely assessed, the responsibility of the patient is poorly understood. The main objective of the study was to look for patient-specific predictors of metal vestibular attachment detachments. An historical cohort study was carried out from adolescents having benefited from a fixed vestibular appliance treatment lasting 27 months +/- 3 months, having all teeth from first molar to first molar on arch to pose. Univariate and multivariate analyses were performed by logistic regression. 333 patients were included. In univariate analysis, boys tended to take off more than girls, patients in skeletal Class II more than those in Class I, those with at least two cooperative remarks more than those with less than two remarks. The percentage of patients with debonding increases with the number of hygiene remarks. Younger patients were more prone to debond than older patients. The "age" factor has a significant effect in multivariate analysis. Neither the vertical skeletal pattern nor the socio-economic level would intervene in the rate of debonding. The role of patient-specific factors in detachment should be put into perspective. The reliability of the results would be increased by a prospective study using validated indicators of compliance.

Introduction: Amelogenesis imperfecta is a genetic disease, characterized by a structural defect of the enamel and has variable clinical expressions. It can be isolated or associated as part of a syndrome. Three clinical forms exist: hypoplastic, hypomature and hypomineralized.

Discussion: Enamel fragility involves dentin exposure and dental hypersensitivity as frequent consequences. Some severe forms are mainly associated with an anterior open bite. The care of these patients constitutes a real challenge for the dentist. Materials et Methods: A literature review was carried out using the PubMed, Web of Science and Scopus interfaces over the past ten years in order to highlight the different treatment options available.

Conclusion: From conservative to surgical treatment, it is necessary to develop a collaboration between the orthodontist and the pediatric dentist in order to offer multidisciplinary care adapted to the patient's needs.

The relevance of Class II interceptive therapy is controversial. The objective of this literature review was to note its indications and if a benefit is proven. We carried out a systematic search on PubMed from 1999 to 2019 by keywords on randomized trials. Fourteen articles were selected, mainly grade B or C. The criteria evaluated were dental, skeletal, psychological, aesthetic, as well as cost, duration, incisor fractures, rate of stroke, complexity and treatment need. Overjet is an important criterion for the indication of interceptive treatment, but it is not the only one. The skeletal criterion, assessed mainly by the ANB, is only significant for three articles; the improvement of self-esteem is proven in one article and the interceptive treatment allows an aesthetic improvement (alignment of the maxillary incisors). The overall cost of treatment would be higher for two-step treatment. In only two articles, the authors wonder if the interceptive treatment facilitates future treatment. The rate of compensatory strokes and extractions are widely studied. The main criteria studied are ANB (controversial indicator), incisor fracture rate (trauma) and overjet. Certain non-significant results must be put into perspective with the aim of the studies and the methods used.

Egression and orthodontic traction can lead to parasitic movements on the anchoring elements. It is often necessary to use a device including several dental elements sometimes associated with traction auxiliaries. The author, through clinical cases, will develop his therapeutic approach, to limit these parasitic movements as much as possible. The use of a bone anchorage associated with a cantilever arch improves the management of this frequent orthodontic problem.

The management of adolescents in the orthodontic practice remains a challenge in terms of motivation and adherence to treatment. Some factors seem to be of paramount importance in the success of treatment. The objective of the present study was to evaluate the motivational factors of adolescent patients seeking orthodontic treatment using the Q methodology. After interviews with adolescent patients, 32 reasons for seeking orthodontic treatment were identified and ranked in order of importance on a Q methodology grid by 40 patients aged 10 to 16 years. Factor analysis was used to classify the patients' views into groups of shared opinions. Four motivating factors were identified in adolescent patients. However, the factor « the advice of general Dentist and the aesthetic need » was the most important. An effective treatment strategy can be chosen for each patient according to their motivational profile; this could therefore improve their cooperation and guarantee a more satisfactory therapeutic outcome.

Due to many innovations, bonding in the sense of bracket positioning is continually remodeling itself. Therefore, we wanted to define what a good bonding was and how to achieve it, both by identifying factors that could alter it and by evaluating the bonding assistances currently available. We carried out the synthesis of 65 comparative studies from PubMed. The inter-individual variations in dental morphologies are greater than the differences in the prescriptions available for the brackets. Tweed's bonding procedure at constant heights alters the leveling of the marginal ridges of the posterior teeth. The gauge improves the vertical positioning of the brackets, regardless of the clinician's experience. There is no clinical evidence to a superior efficiency of individualized techniques. The prescriptions of Mc Laughlin and Bennettseem more aesthetic than those of Andrews for the anterior teeth. The avail of indirect bonding is not obvious. Individualization is necessary in lingual technique, but does not allow better results in vestibular technique compared to conventional standardization. Evolutions are to be expected with the modeling of the individual biological response to induced tooth movement. While digital assistance is promising, it does not replace the expertise of the orthodontist.

Even if miniscrews are mainly used in the active phase, their uses during the contention have been reported for a few years either by installation of miniscrews de novo or by taking advantage of miniscrews inserted during the active phase. The objective of this article is to describe the uses - reported in the literature - of miniscrews during the retention phase. We have conducted a research from the database PubMed with keywords associations. Nineteen articles were found with three indications: to temporarily replace toothlessness while awaiting the final prosthetic solution at the end of growth while maintaining bone level; to contain open-bite treatments in order to avoid as much as possible the relapse; to improve the comfort and aesthetics of Hawley plate. This prospect of using miniscrews after active treatment further opens up the field of possibilities. However, there is the problem of osteointegration and bone damage caused by the removal of miniscrews linked to the maintenance of miniscrews over the long term.