This article reviews the normal and pathological healing processes that take place after tooth extraction in orthodontic cases, and their associated complications within the mucosa or alveolar socket, such as gingival clefts or bone defects. The general and local factors that are involved in such deficient healing cases are detailed, in parallel to surgical procedure to enhance ridge preservation or to ‘regenerate’ tissues. The relationships between the orthodontist and periodontist are underlined, because both praticioners assess patient's risk factors and follow him during this treatment stage.

By definition, orthodontists take special care in achieving a high quality occlusion when finishing cases, believing good contacts are essential to maintain dental health, function, and insure stable long-term of results. The T-scan III system provides a real-time digitized analysis of occlusion, in both static and dynamic modes, and records the distribution of occlusal forces within the dental arches in different clinical situations. While the first T-Scan generations versions showed weaknesses, recent technical improvements have made T-scan a reliable and reproducible tool, whose findings are independent of the operator. It is now possible to calibrate the sensitivity of the sensor for individual patients, and to evaluate the quality of records so that comparisons can be made between various stages of a patient’s treatment, as well as between patients. In addition to the accuracy of occlusal diagnosis, that often exceed clinical requirements, the T-scan III also can help understanding better each patient’s functional pattern. This article describes the T-scan III occlusal analysis system, reviews current literature that evaluated its clinical use, and outlines its principal indications in dentofacial orthopedics. Four clinical cases treated with full bonded lingual appliance will illustrate how the Tscan III influences orthodontic case finishing : one case of “occlusal discomfort” after completion of surgical and orthodontic treatments, a case of cervical abfraction lesions, a case of anterior deep bite restored with an implant-supported prosthesis, and a case of severe facial hemiatrophy treated with a complex protocol.

Dental wear is deterioration as a result of use. It has existed since the beginning of mankind in all civilizations and cultures. It occurred routinely and intensely in early populations but was considered to be a physiological process. Ideas about dental wear are not as clear today because while it is less pronounced it sometimes appears in pathological patterns. Moreover, it is produced by many complex mechanisms acting in synchrony or sequentially, in synergy or additive, in patterns that often mask its true origins. In an effort to ameliorate the means of preventing and diagnosing dental wear and improving our understanding of its diverse manifestations, the primary objective of this article will be to present the principal mechanisms that produce it as well as their consequences. To organize our presentation we have adopted a tribological approach, focusing on the friction, wear, and lubrication of interacting surfaces.

Practitioners should aim to diagnose as early as possible the development of malfunction of the masticatory system, or temporomandibular disorder (TMD), that causes pain, discomfort and a decrease in functional efficiency, especially in those patients whose occlusion is being rehabilitated in the course of orthodontic treatment. This is particularly true for the segment of the patient population who are characterized by certain risk factors.

Armed with a good understanding of the diagnostic classification of TMD, orthodontists will be better prepared to pinpoint and diagnose TMD and, if necessary, adopt the most appropriate mode of therapy for treating it.

Thanks to a good understanding of TMD nosology, orthodontists will be able to distinguish between muscular and joint disorders and then manage patients in accordance with specific diagnostic criteria.

There are many ways dentists can restore teeth prosthetically. Depending on its condition of relative integrity or more serious breakdown and the patient’s loss of other teeth, the practitioner can choose from a variety of quite different procedures ranging from the fabrication of a single ceramo-ceramic crown on a vital tooth to correction of considerable loss of teeth with an implant supported bridge. This paper will evaluate most of these treatment modalities and, in addition to purely prosthetic considerations, will discuss the integration into treatment of periodontal, implant, occlusal, and functional concepts.

Orthognathic surgery has as its objective the repositioning of basal bone in the framework of maxillo-mandibular deformities. Its results are both esthetic and functional. For adults, improved aesthetics results is becoming increasingly important in these procedures to the point where some patients seek only an esthetic amelioration and not a functional one. To achieve their aesthetic purpose, it is becoming progressively more necessary for orthodontists, oral surgeons, and general dentists to collaborate effectively in a well-coordinated effort. In what has now become a true sub-specialty, orthognathic surgeons must master the complementary techniques of rhinoplasty, osseous apposition, aesthetic facial surgery, fat injection or injectable anti-aging tratments. In this article we propose a diagnostic classification based on the aesthetics of the adult smile and describe the therapeutic modalities appropriate for each element.

External root resorption is a feared complication during orthodontic procedures. It can affect both the apex, but also the cervical zone of the roots subjected to orthodontic forces for tooth movement and can compromise the future of the involved teeth. The patient must be informed about the risks of resorption as a consequence of orthodontic treatment. The detection of resorptions can occur during and/or after the active phase of orthodontic treatment.

Knowledge of the clinical situations predisposing the patient to resorption is essential. The data are still insufficient to avoid them completely. Early and precise detection is essential, and the cone beam with its high resolution 3D images, can compensate for the diagnostic inaccuracy of digital panoramic and periapical films. There are treatment solutions and their prognosis is correlated to early detection. Apical resorptions, generally not infected, can mostly be stopped by discontinuing orthodontic forces. Cervical resorptions, with a bacterial component, will require surgical intervention with curettage and restorative build-up of the resorbed area. Current research, particularly in genetics, is in the developmental stage. In the future, the conclusions of this research will allow orthodontists to more precisely target at risk patients so as to avoid these complications.

Biometric study of contemporary human maxillary incisors and canine coronal morphology

The orthodontic alignment or prosthetic rehabilitation of the upper anterior sector is based on available biometric data.

The aim of this study is to measure the angle formed between the functional lingual surface of the canine and central incisor and the axial-orbital plane.

Materials and methods

This retrospective study is based on an analysis of documents of young dental students.

The measurements were made on 49 silicone models of healthy, natural, functional teeth, in class I occlusion for the maxillary anterior group.

Results

The values of slope angulations of the lingual surfaces relative to the axial-orbital plane clearly decrease by 10° from the central incisor (57°) to the canine (47°).

If there is stability in buccal morphology, there is variability in anterior lingual morphology, particularly of the canine.

These variations in an essential zone on the functional level are marked enough to warrant being taken into account in clinical practice.

Rare diseases represent a major public health challenge due to their number, presently estimated to be between 6000 and 8000, their severity and the absence of any preventive treatment. The enactment of two National Plans for Rare Diseases by the establishment of Referral Centers and Diagnosis and Treatment Centers has brought about a recognition of the specificity of these disorders, the creation of a epidemiological database, a framework for rapid diagnosis protocols at the first symptoms, greater access to specialized care to accompany the afflicted and their families during their frequently difficult medico-social journey, training of skilled health professionals in the field of these rare diseases, promotion of basic and clinical research and finally the development of European partnerships in both research and therapeutic planning.

Dentists often use occlusal splints in the management of occlusodontic problems. Because they are considered to provide non-invasive and reversible treatment they are therapeutic devices that conform well to the current philosophy governing protocols for therapy of the masticatory system. Proper design and placement of occlusal splints requires that they respond to precise indications and that practitioners fabricate and maintain them with scrupulous care to assure that patients benefit from them. Splints help practitioners adjust the relationship between the jaws either by suppressing blockage of teeth to relax muscles or by repositioning the condyles in the articular fossas to recapture discs or to reduce painful excess intra-articular pressure derived from degenerative diseases.

Occlusal splints are also suitable as diagnostic tools to validate and evaluate contributions of behavioral, postural, and psychosocial factors to the multifactorial etiology of malfunctions of the masticatory apparatus. The simple introduction into a patient’s mouth of an appliance whose benefits have been well described to that patient will serve as a forward step in the psychological management of a TMD problem, especially if bruxism is one of its components.

Current evidence based data found in the scientific literature recommend that the therapeutic management of patients suffering from temporomandibular disorders (TMD) should be based initially on simple, conservative and reversible procedures including exercise therapy. The integration of this message into oral health instructions for patients makes it easy for them to keep informed about TMD and aware of the steps they can take to deal with their symptoms. The integration of exercise therapy into structured patient education programs provides patients with information about TMD and suggests methods to deal with it. This medical approach is similar to those used to treat other joints in the musculoskeletal system.

Easy to set up, this exercise therapy helps patients suffering from temporomandibular disorders to become partners in the conduct of their treatment plan of reducing pain and restoring functional comfort.

More and more adults are beginning orthodontic treatment because they want to regain the smile they had when they were 20 years-old and to diminish the signs of aging their faces present to degrees that depend upon the severity of their dento-facial deformity.

The dental esthetic criteria that are sought after and regained with treatment are, primarily straightening and whitening of teeth, and a smooth appearance of the teeth and their mutual contours, predominantly in the upper incisor area as well as a regular, broad smile line in harmony with the lower lip. In addition to these dental guide lines, additional important consideration should be taken of the relationship of the size and bulk of the teeth with respect to facial type and the absence of any strain in lip posture.

Orthodontic treatment, in correcting malocclusions of varying severity, can effectively join with other specialties in creating a younger smile line for patients and eliminating many signs of aging.

Angle corrected anterior crowding by advancing the crowns of the incisors. For a long time he hoped the apices would follow along spontaneously. Then because of the uncertainty of this reaction, he started his quest for an appliance that would be able to accomplish root movement. The first one was difficult for orthodontists to manipulate, the second did not incorporate vertical control, but the third had all the qualities Angle was looking for. He died satisfied.

This article shows how to apply orthodontie force to impacted cuspids and bring them into proper arch position using a unique innovative anchorage system consisting of two short mini-screws placed buccally in cortical bone. Attached to this fixed anchorage is an .018 TMA round wire that emerges from the gingiva to exert direct 3D control on the canine without any additional dental support. The general procedure for moving impacted teeth into position and the mechanics utilized are described in detail with illustrations from clinical cases we have treated.

The canine is a tooth with special characteristics and adaptive significance that varies considerably between mammalian lines and the primates. No matter what the line, canine teeth are never involved in mastication and do not interfere with masticatory dynamics. Mastication, which is one of the most complex functions that monkeys and apes display, appears well before the large canines in both phylogeny and ontogeny. In apes, their size and shape have nothing to do with diet, but are linked to sexual selection. The human line of hominids possesses smaller canines that have become incisiform and have lost their sexual and social function. They are now used exclusively to tear apart meat and other types of solid foods. The development of a wide, short buccal surface that increased medial-lateral movement during the masticatory cycle, may explain this particular development in recent hominids including humans. From an evolutionary point of view this means that the human canine has been subjected to stresses imposed by the biomechanical environment of the masticatory apparatus. In other words, the human canine, as well as those of the other anthropoids, does not guide mastication but has acquired a morphology and position restricted by masticatory functions. In evolutionary terms, it is therefore referred to as an “exaptation”; it has acquired, not a function, but a passive characteristic which makes it a marker for rehabilitation – on condition that its eruption is related to normal masticatory functions in individual histories, but it never serves as a mediator of mastication.

Introduction: Spina bifida is a rare congenital disorder due to a closure anomaly of the neural tube.

Clinical case: A 9 years-old girl presents with lumbar spina bifida aperta and cervical spina bifida occulta. Her case illustrates the importance of orthodontic xrays in the diagnosis of cervical spine malformations.

Discussion: There are two categories of spina bifida. When refered to as aperta, the disorder associates a dorsal vertebral bony gap and an involvement of the spinal cord. A skin pouch can form and include meninges alone (meningocele) or meninges with spinal cord (myelomeningocele). Spina bifida is generally located in the lumbar or sacral regions, and extends over 2-3 vertebrae. On the other hand, the involvement of the cervical spine is often of the occulta type, where the defect is covered by skin and is limited to the bone. This rare condition cannot be ignored by the clinician as the craniocervical junction anomalies induced by this malformation can be associated with C1-C2 instability, as in our case report.

Orthodontists, thanks to their keen appreciation of facial morphology and their skills in making functional examinations, are ideally placed to detect breathing problems in their patients that can require an ENT assessment, with special attention paid to the evaluation of sleep patterns. After a site of obstruction, resulting from a soft tissue anomaly and/or a narrowing of the airway passage through bone, has been established, orthodontists may be called upon to undertake corrective treatment sometimes in conjunction with a surgical procedure.