Pierre Fauchard (1678-1761) is known as the father of dentistry. This division of medicine participated fully in the enlightenment. After a second reading of his book, The Dental Surgeon, an examination of recent publications of 18th century practitioners, and the discovery of new documents, we have gained a better understanding of the man, the dental surgeon, and the place of scientists in his century.

This article reviews the main trends in the evolution of the vertebrate axial skeleton, with special focus on mammals. The structure of vertebrae is exposed according to traditional and current conceptions and several examples of species-specific and topography-specific adapta tions are given. The relationships between stature and the anatomy of the bony girdles surrounding the spine are discussed. Hypotheses on the influence of gravity on axial morphogenesis are formulated.

Parents want their children’s’ faces, the most visible part of their bodies, one that marks their identity throughout life, to be perfect. To satisfy this understandably urgent desire, a high quality of primary treatment for cleft lip and palate is essential and must satisfy a double objective: restore normal morphology and normal function. The functional, morphological, and esthetic prognoses depend on the character of the defect, whether it stands alone or is associated in a syndrome with other malformations. Important sequellae flow from the quality of the initial repair, as a consequence of the surgery and other therapies as well as from the deformity itself.

Before the year 2000, the Maxillo-facial and Plastic Surgery Service at the Armand Trousseau Hospital of the Pierre and Marie Curie Faculty of Medicine adhered to the protocol that Malek had described, making an initial repair of the soft palate at 3 months and then a cheiloplasty, with upper and lower triangles, and closure of the hard palate at 6 months. Since then we have adopted the more functional approach that Talmant described, integrating systematic nasal surgery and the type of lip surgery that Millard suggested without leaving any residual exposed bone after closure of the osseous cleft. We then perform gingivo-periosteal surgery with bone grafts on patients when they were between 4 and 6 years of age, after orthodontic therapy had been completed. This constitutes the last stage of primary treatment.

The therapeutic approach we have been using on our service, which has evolved of over the last 20 years, has come to define its principal objective as integration of extensive rehabilitation into the very first stages of our multi-disciplinary therapy so as to minimize the establishment of faulty functioning of phonation, lip competence, and ventilation while avoiding any intervention that would have a harmful impact on facial growth. This multi-disciplinary approach, which integrates surgical evaluation and protocol, is indispensable and fully justifies treatment of patients with cleft lip and palate at accredited centers.

The objective of this nonsystematic review of the literature is to determine whether or not self-ligating brackets are an equally effective alternative to traditional brackets for non-extraction treatments. The agreed upon criteria are indications for extractions, the biomechanical approach, the stability of the treatment results, the iatrogenic effects and the ergonomics.

The studies discuss arch expansion with the use of self-ligating brackets. One study mentions a lack of control of osseous management including tipping and buccal bone thickness in the lateral sectors. The mandibular incisor inclination that was obtained does not appear to be correlated to the type of bracket but rather to initial factors specific to the patient. We didn’t find any study dealing with the long-term stability of the results.

Regarding patients, self-ligating brackets do not reduce the pain, the number of extractions, the incidence of resorption or the risk for caries. Self-ligating brackets shortened the clinical time for an experienced practitioner but not the length of the time of comprehensive treatment and alignment. Some studies report an increase in cases of emergency. Finally, these brackets are more difficult to position.

The last stage of orthodontic treatment is occlusal finishing. This complex and subtle treatment period demands careful reflection by orthodontists in order for them to achieve an optimal occlusion.

Elastodontic concept is a straightforward therapeutic tactic, whose essence is a considered and individualised approach to treatment within a well-structured plan.

Elastodontic concept enables orthodontists to construct of a functional occlusion which satisfies the three fundamental criteria of function of the masticatory apparatus: effectiveness, harmony, and economy.

An illustrated case study will give the reader an understanding of the design and unique action of this type of appliance.

The tonic postural system controls the equilibrium of posture when the body is completely at rest and when it is moving. It is a complicated mechanism that can call into action a variety of modalities including the assistance of the feet, the skin, the eyes, the masticatory system, the Central Nervous System and the efferent muscles, with all elements working reciprocally. Orthodontists should make a postural assessment before undertaking any treatment. If problems are found they should be dealt with by a multi-disciplinary team. But in every case orthodontists should be aware that their efforts have an effect on posture and can modify the corporal schema of the patient. Orthodontists should pay special attention to patients with scoliosis or any deformity of the spinal column.

The surgical treatment of maxillo-mandibular malformations accompanying cases of hyperdivergence should aim at achieving good function for the patient by increasing space available for the tongue to move in and for proper respiration to take place and by reducing the tensions affecting muscles and ligaments either by dis-inserting them or by moving skeletal structures in the direction that muscles attached to them contract. An analysis of the literature shows that by respecting these principles surgeons can obtain good results in the majority of cases even in instances of extreme deficiency of the body of the mandible or where lengthening of the ascending rami is required. For these patients a cooperative effort of the surgeon and the orthodontist becomes even more than ever indispensable. In addition it will be necessary for the treatment team to follow these patients for an extended post-operative period.

Behavioral therapy (or myofunctional re-education) acts on the central nervous system and not directly on facial tissues like other orthodontic treatment. This therapy was developed in two stages: first, orthodontists identified the role played by muscular pressure on the shape of dental arches (Blandin4, 1836), then by the elaboration of remedial treatment of malfunctions as well as the elimination of parafunctions (Johnston20, 1938). The School of Stomatology introduced these treatment methods in France in 1950.

Describing an anatomical shape with a landmark points diagram allows the practitioner to use all the tools of geometric morphometry. Using a 14 point trigeminal for maxillofacial morphology, 10 points for basicranial morphology and 6 points for the orbital area, we have been able to identify the specific maxillofacial shapes associated with the major dysplasias (Class II or Class III ‘‘surgical limit’’) or simple malocclusions and to research the possible relationships between basicranial morphologies and maxillofacial morphologies. The asymmetries have thus been linked to other pathologies.

We have compared these results with those obtained by using a three-dimensional cephalometric analysis and with results obtained from the literature.

The conclusions on the epidemiology of the asymmetries are in agreement. Basically, the mandible with dominance of the right hemi-face was confirmed as the causative factor. The stability of the basicranial shape makes a solid case that it is not responsible for maxillofacial or occlusal pathologies.

In general, the smile that orthodontists try to create at the end of treatment satisfies objective functional criteria as well as subjective esthetic criteria.

It’s obvious that in today’s society, a smile plays an important role in nonverbal communication: restoring or enhancing this smile is, in fact, the main reason patients consult their orthodontists.

After reviewing the literature, we were able to identify various factors involved in the perception of a smile and to underscore the esthetic connection between the smile and the face.

Is there a relationship between the smile and facial harmony?

What are the objective criteria that allow us to discern whether a smile is pleasant or not?

Our study confirmed that the esthetics of the face correlates with the perception of the smile and that the factors discussed in the literature pertaining to this correlation are valid.

However, the study has also made it possible to clarify the respective influence of various factors as they relate to a pleasant smile, an unattractive smile or an unsightly smile. Therefore, our study has shown that objective functional criteria are involved in the entirely subjective esthetic realm of a smile.

Orthodontists and maxillo-facial surgeons are very aware of the different therapeutic options for the correction of maxillary transverse deficiencies. But what about mandibular transverse deficiencies? A number of dentofacial orthopedic mandibular expansion techniques have been suggested, but they often have a tendency to relapse. Symphyseal distraction is the easiest solution for the correction of mandibular transverse defects, particularly in cases of a major deficiency such as Brodie’s Syndrome. In addition to recreating a physiologic occlusion, this technique makes it possible to considerably increase the width of the bony and soft tissue that not only improves the patient’s function and esthetics, but also helps to ensure long-term occlusal stability as well.

Despite having a correct anterior occlusal relationship between upper and lower teeth with canines in perfect Class I, some patients have imperfect posterior occlusal relationships with first molars in positions that are slightly Class II or Class III owing to an arch length discre pancy in the upper and lower buccal segments.

From this study of 62 subjects treated with full banded appliances and no bicuspid extrac tions we were able to determine the ideal relationship of the widths of the lower bicuspid and molar teeth with their upper antagonists, one that make it possible for the attainment of Class I relationships of both canines and first molars. This ideal value is 1.062.

We discuss the therapeutic implications of this finding, notably its influence on extraction decisions and propose solutions for cases of frank disharmony.

This article offers a series of justifications for early interceptive treatment as opposed to later treatment that might necessarily involve the extraction of permanent teeth. The biological responses of the membranous sutures, of the periosteum, of the periodontal ligaments, and of the condylar cartilages but also of the potential for growth in stature, well before the pre-pubertal growth spurt and the administration of effective treatments, are also reasons that support an early phase of treatment, in the early mixed dentition, even in the primary dentition!

Some early orthodontic or orthopedic treatments and their appliances such as buccal screens, myofunctional trainers, occlusal splints or sectional expansion plates and other maxillary expansion and protraction appliances are useful for correcting deformities or severe under-developments that are already in place.

But myofunctional re-education, when carried out according to a structured and prioritized program, is perhaps the most important because these etiopathogenic treatments used to both suppress the causes of the deformations and to restore balanced function, make it possible to re-establish a normal growth pattern and perhaps consequently, to avoid the need for extraction of permanent teeth.

A cross bite of one or more anterior teeth can interfere with the function of the incisocanine block in guiding mandibular escursive and protrusive movements out of a position of occlusion.

When this type of malocclusion occurs without any associated skeletal imbalance,orthodontists can correct it with relative ease by using a variety of well-documented appliances. The objective of this article is to describe a myofunctional approach for dealing with this problem.

In it, the orthodontist first removes the cross bite’s blockage of tooth movement by placing glass-ionomer cement blocks on the occlusal surfaces of posterior teeth. When this is done the tongue, labial, and cheek musculature can accomplish their role, without inhibition, of correcting positions of the dentoalveolar arches in two or three months.

Self-ligating brackets have become increasingly established in orthodontics in recent decades. While proponents haveprofessed overwhelming advantages of self-ligation, most notably a reduction in treatment time and a reduced requirement for extractions, there has been little convincing evidence to support many of these claims. In this review the evidence concerning the influence of self-ligating brackets on the efficiency of orthodontic treatment is considered.

The use of distraction osteogenesis to improve the airway volume of individuals affected by craniofacial anomalies is common practice today. The methods of assessing the outcomes of such surgical procedures have changed over the last several years.

Objective : The objective of the present pilot study was to determine if the CBCT imaging modality may serve as a simple and reliable method for craniofacial practitioners to evaluate airway volume changes following distraction osteogenesis.

Materials and Methods : Twelve patients who had previously undergone distraction osteogenesis for the primary purpose of improving their airways were enrolled in the current study. Pre (T0) and post-surgical (T1) CBCT’s volumes were analyzed to measure the nasopharyngeal (NP) and oropharyngeal (OP) volume changes. InVivoDental 4.0 (Anatomage Inc., San Jose, CA) (IVD) program was used to visualize and render the oropharyngeal (OP) and nasal passage (NP) volumes, separately. Means and standard deviations were calculated.

Results : Of the 7 males and 5 females in the study, 4 patients underwent mandibular distraction (MandDO) and 8 underwent maxillary distraction (MaxDO). Four in the MaxDO group were treated with internal distractors and 4 were treated with external distractors. Individuals who underwent internal MaxDO greatly improved their NP volumes (1605 ± 1736 to 3273 ± 3130 mm3) as did patients who underwent external MaxDO (5763 ± 5077 to 9243 ± 9442 mm3). In comparison, the MandDO group’s NP volume showed modest gains (3519 ± 1944 to 3894 ± 2516 mm3). With regard to the OP volumes, the MandDO group gained substantially (4906 ± 2347 to 11385.8 ± 6393.5 mm3) while the MaxDO groups showed humble increases; internal MaxDO group (1779 ± 273.8 to 2639.5 ± 898.4 mm3) and the external MaxDO group (8959 ± 5311 to 9734.13 ± 7124.7 mm3).

Conclusions : In the present preliminary study of assessing airway volume changes using CBCT on patients who have undergone different DO techniques, MandDO greatly increases OP volumes and MaxDO tends to increase NP volumes. The CBCT imaging modality holds great promise for craniofacial practitioners in its application to assess airways of individuals affected by craniofacial anomalies.

Impacted upper canines occur, in buccal or palatal sites, in about 3% of the population and pose a threat to neighbouring teeth. Before orthodontists can bring them into their proper positions in the arch, oral surgeons often have to uncover them. In this article we discuss the traction pathways, open or tunnelised, that orthodontists can then use to begin moving them. While orthodontists can use both techniques successfully, they should understand the advantages and disadvantages of both before making a decision.