L'' Orthodontie française最新文献

This systematic review aims to compare conventional corticotomy with minimally-invasive protocols (MIP). Electronic database, in MEDLINE and CENTRAL, and hand search were performed. Randomized controlled trials (RCTs) and randomized split-mouth designed studies (RSMSs) were selected for inclusion, reporting either the use of a corticotomy procedure or a MIP. The main outcomes were the rate/velocity of tooth movement, type of tooth movement observed, loss of anchorage, periodontal indexes, inflammatory mediators, root resorption, patient's pain experience, impact on the quality of life, and satisfaction. Twenty-two papers were included for the qualitative synthesis, from which ten RCTs and twelve RSMSs. Eighteen of them compared a conventional orthodontic treatment without and with a surgical adjunctive procedure, two with conventional corticotomy and sixteen with a MIP (piezocision, micro-osteoperforations (MOPs) or interseptal bone reduction). Four trials compared a surgical procedure to another one. Corticotomy, piezocision and MOPs are likely to accelerate tooth movement, in decreasing order. Pain is reported to be higher in experimental groups only on the first day after surgery. Patient satisfaction is high after surgical procedures. Loss of anchorage, periodontal indexes, or root resorption occurrence show no differences between groups. Corticotomy stands as the gold-standard procedure for surgically-assisted orthodontics, but piezocision appears as a good compromise solution as well as MOPs, in a lesser extent. MIP are known to accelerate tooth movement only during the first three months.

In order to guarantee optimal care for our patients during orthodontic-surgical protocols and given the large number of interveners, some special cases request an even closer collaboration between practitioners. This article presents the very specific cases requiring even closer collaboration and specific care in order to optimize appointments. The collaboration between the surgeon and the orthodontist is particularly essential and will guarantee the excellence and the precision of the final result.

Introduction: The objective of this study was to evaluate, through a systematic review of the literature and an in vitro study, the alteration of the mechanical and chemical properties of aligners after aging in artificial saliva and in the oral cavity.

Materials and methods: A systematic literature review was carried out, through an electronic consultation of three databases: PubMed, EBSCO and Sciencedirect, between September 2018 and January 2020. The search was guided by the use of several specific keywords. In our in vitro study, the mechanical properties of our sample of aligners were evaluated using the 3-point bending test after a water immersion.

Results and discussion: Of the 189 articles found, only six articles met our inclusion criteria. In the light of the studies selected in this systematic review and of our in vitro study, it can be concluded that the orthodontic aligners undergo an alteration in their mechanical properties after stay in the mouth. However, the real impact of these modifications on their clinical performance remains to be demonstrated and it is difficult to make a final judgment on their chemical stability. Other controlled clinical studies, with protocols better suited to the clinical criteria studied, are necessary to objectively assess the aging phenomenon of orthodontic aligners.

The Ehlers-Danlos syndrome (EDS) is a group of genetic connective tissue disorder due to abnormal collagen synthesis. EDS is characterized by the triad: joint hypermobility - skin hyperextensibility - connective tissue friability leading to vascular and skin fragility. Thirteen forms exist including three main ones: the hypermobile, classical and vascular forms. Given the diversity of clinical manifestations, the diagnosis of EDS is difficult. The management of this syndrome is multidisciplinary and includes the dental surgeon, because EDS can have many oral and dental manifestations. This syndrome can lead to dental, periodontal, mucosal damage and also to joint damage to the manducatory apparatus. The authors, after describing the symptoms of EDS, their manifestations and their detection, will explain the implications in odontostomatology. EDS must be known to the dentist because it can lead to precautions during dental care, and because patients with EDS are more prone to temporomandibular disorders. At the last, the many oral and dental manifestations of EDS give the dentist an important role in screening for this syndrome.

There is often a dysfunctional dimension with poor oral habits and parafunctions in the etiology of malocclusions. A multidisciplinary care seems essential. Through a review of the literature, this article analyzes old and current theories on the origin of parafunctions and the therapeutic possibilities for their correction. Our therapeutic approach to correct these parafunctions must take into account the behavioral approach, which can have a beneficial effect, but also the neurobiological approach. The current evolution in neuroscience now allows us to better understand the origin of these parafunctions and facilitate a better approach for their correction through behavioral methods. Taking into account the psychological and blood pressure dimension of our patients increases the chances of success. The use of removable or fixed devices can complete this therapeutic approach.

Posterior open bite is a malocclusion characterized by the absence of vertical contacts between the occlusal surfaces of the posterior teeth of the opposing arches. It can be uni- or bilateral and involve one tooth or more. Several aetiologies of these posterior open bite have been described, including pathological eruptions, dento-maxillary dysmorphosis and temporo-mandibular dysfunctions. When considering a correction or compensation, there are several therapeutic options (orthodontic and/or surgical and/or prosthetic). Recent developments in adhesive dentistry (bonding biomaterials, ceramics and composites) have made possible the development of more conservative approach for restorative and prosthetic treatments. In order to understand the possible use of these restorations and the help it can provide in our treatment plan, we have selected three original clinical situations. Each one illustrated a posterior open bite aetiology and explained the rehabilitation strategies chosen (process of decision making and realization). Partial bonded restorations (direct composites, overlays, tabletops, veenerlays) can be considered to compensate open bite, in case of impossibility, failure or as a complement of orthodontic treatments. Additive equilibration is not described in the literature for the compensation of posterior open bite, despite the many functional advantages along a simple and conservative technique.

In last decades, the number of adult patients requesting orthodontic treatments has increased. Orthognathic surgery allows correction of skeletal dysmorphoses in adults. The management of osteoporotic patients treated with bisphosphonates is a major challenge for orthodontists and maxillofacial surgeons. Few studies have been conducted in these patients and four cases of orthognathic surgery have been described to date. A rare case of orthodontic surgical treatment in an osteoporotic patient who has been treated with bisphosphonates is reported. A 38-year-old patient wishing to improve the aesthetics of her face presented in dentofacial orthopedic consultation. Anamnesis revealed a history of bisphosphonate treatment for osteoporosis. The patient presented a hyperdivergent skeletal class III with laterognathia. The occlusal diagnosis was a class III with premolar and canine open bite, interincisal media discordance and dental crowding. The patient was treated by orthodontics and maxillomandibular osteotomy. A postoperative bone Healing delay of four weeks was recorded. This case report discusses the possibility of performing orthodontic treatment associated with orthognathic surgery in patients treated with bisphosphonates in context of osteoporosis. Orthodontics and maxillofacial surgeons must be prepared for the management of patients treated with bisphosphonates. Studies should be considered in order to specify the optimal methods of management.

The biomechanical adverse effects generated by our treatments must be considered among the failures of mini-implants, certainly excellent means of anchorage. The aim of this article was to illustrate and comment on mechanical adverse effects and to propose solutions. Four common clinical situations in vestibular technique are analyzed, decomposed three-dimensionally and solved. Maxillary incisor intrusion in direct traction (mini-implant between lateral incisors and canines in direct anchorage) can lead to a disto-labial rotation of the supporting teeth and an incisor flaring. Maxillary incisivo-canine retraction (mini-implant between 5 and 6 in direct anchorage) leads to a canine rotation, a clockwise rotation of the occlusal plane and a version of the adjacent teeth. The maxillary molar two-steps distalization (mini-implant between 5 and 6 with metal ligation to the canine) causes a rotation of the adjacent to the spring teeth, an incisor flaring and a molar disto-version. The protraction of a mandibular molar (mini-implant between 3 and 4 in direct anchorage) causes a disto-labial rotation, a lingual torque and a mesio-version of the molar as well as an incisor flaring and a clockwise rotation of the occlusal plan. The compensation bends on the adjacent teeth, the choice of the location and the type of mini-implant, the use of a power arms to get closer to the center of resistance are among the means of resolution. If mini-implants anchorage allows a significant quantitative effect, adverse effects should be considered individually with a three-dimensional biomechanical analysis.

Although adult patients are said to be demanding in terms of discretion of the orthodontic appliance, the factors influencing the choice of the appliance are still poorly understood. The main objective of this study was to determine if there is a correlation, in adults, between the importance of the orthodontic treatment need and the aesthetic preference of the orthodontic appliance (metal braces, ceramic braces in buccal, lingual or aligner). The secondary objectives were to evaluate the impact of the patient's personal factors, his eventual orthodontic past and his perceived orthodontic need. Patients were interviewed by questionnaire before the first consultation. An index, depending of the discretion of the appliance, was used. The need for treatment was calculated via dental health component and aesthetic component of IOTN. Given the size of the sample, only trends can be emitted. The real need for treatment had no influence on the choice of the aesthetic appliance. The most demanding patients would be women, in their thirties, single, employed, executive or practicing a higher profession, with previous orthodontic treatment and having recently consulted an orthodontist, as an adult. These patients felt that their orthodontic treatment need was minimal or significant. Patients estimated the duration of treatment at 17 months. Lingual was considered the most aesthetic appliance far ahead of the aligners. A larger scale study is needed to determine the influence of each factor.

Widely used, especially for supra-implant solutions, the indication of attachments is now extended to orthodontics. The objective of this series of cases was to describe three clinical situations in which attachments on miniscrews have been adapted to orthodontics, leading to the development of a new connection: the ball attachment or Ball Abutment making it « semi removable » anchoring devices which until now had to be fixed. A series of three cases is presented. For each case, the miniscrew(s) already in place during the active orthodontic treatment phase is (or are) used with a palatal device (palatal plate or palatal expander). In the latter case, the Ball Abutment, of relatively simple use, is fixed over the miniscrews allowing the device to offer controlled looseness. This attachment allows the clinician to put in place space-saving devices promoting the retention of the devices, at the border between the fixed and the removable device, sometimes less bulky and more discreet, particularly for adult patients. They could be part of lingual technique treatments. Tests are necessary to assess this orthodontic device in terms of materials, design and retention. This connection offers a new range of possibilities and design of semi-removable passive devices that increase the multifunctionality of miniscrews during treatment.