Condylar hyperplasia is a rare pathology of the growth of the mandibular condylar cartilage leading to facial deformation. A bone scan demonstrates the active or inactive character of the condylar hyperplasia and helps guide therapeutic choices. There are two types of condylar hyperplasia, horizontal and vertical growth. Early condylectomy is the treatment of choice for active forms.

The relationship between occlusion and posture has been a continual source of interest to all participants in the delivery of health care. But a certain amount of confusion still beclouds the subject because of the wide diversity of therapeutic approaches designed to deal with it and the weakness of methodological design in the scientific studies that have been published on it to date.

This article addresses the questions raised by that correlation between occlusion and posture as well as the therapeutic implications of a clinical approach integrating treatment of corporal posture into orthodontic care. A review of the literature shows that there is a dearth of reliable experimental data dealing with this subject. The data that is available points to the existence of this correlation and also asserts the prevalence of associations between idiopathic scoliosis and cranio-facial anomalies in adolescents.

The published facts appear to support our clinical impressions and subjective convictions. In order to enlarge our vision to encompass patients as entire human beings instead of compartmentalized biological segments each to be treated by an appropriate specialty it would be helpful if members of the various medical disciplines improved the lines of communication with each other. An equally desirable development would be the establishment of fundamental research and clinical programs that would help to establish causal relationships that would put therapy on evidence based foundation.

If thickening of gingival soft tissue and root coverage are indicated, these two procedures should be performed prior to starting orthodontic treatment. The decision to initiate these treatments can be made only based on a clinically exact and reproducible diagnosis. The case described in this article is that of a 53-year-old woman presenting Miller Class III gingival recessions from 13 to 23 and 32 to 42. Because of this impairment, she needs orthodontic treatment. The patient’s periodontal biotype is thin.

The objective of the surgery discussed in this article is both to thicken the periodontium of the patient and to promote coverage of the recessions. To achieve these two objectives, we have chosen the modified “envelope” technique with insertion of connective tissue.

The 18 month post-operative results show an excellent rate of root coverage and a significant esthetic improvement of the gingiva.

Since 2005 in France, the national technical committee of prenatal ultra-sound screening (CNTE) has recommended that pregnant women have a routine second trimester ultrasound screening for facial clefts. The view on the coronal reference plane visualizes the continuity of the upper lip, and makes it possible to detect most facial clefts, but not isolated palatal clefts.

Asymmetries are found in every living being. A non-symmetrical structure is not necessarily pathological. Why then, is the diagnosis of asymmetry relevant for us as practitioners? In orthodontics, we can anticipate difficulties with treatment if we are well informed about the principles of symmetry and thoroughly familiar with craniofacial growth.

Severe mandibular asymmetry is relatively rare, appears early and becomes apparent at first sight to the practitioner. We find it associated with syndromes in patients for whom early multidisciplinary treatment is indicated.

Dyssymetry is a defect rather than an absence of symmetry. It is a mild form of asymmetry where the line between pathological and nonpathological is still unclear. The face can present different types of dyssymmetries including the whole gamut ranging from dental imbalance to imbalances of the jaws to cranial imbalances, each with its own signature that leaves its characteristic mark on the face. When dealing with mandibular laterodymorphias, the diagnosis must be made early in order to initiate an individualized treatment plan. We are providing some summary fact sheets that make it possible for the practitioner to clearly distinguish between the principal mandibular anomalies.

The objective of this work is to study the static and dynamic occlusion of dentitions in a Class III molar relationship to determine what might be the indications for treatment that would leave buccal segments in this position, and to evaluate the occlusal adaptions that would be needed to make it functionally acceptable.

Obstructive Sleep Apnea Syndrome (OSAS) is a frequently occurring childhood malady, whose is incidence is largely underestimated, that can lead to serious complications. Because of their understanding of the anatomy and physiology of the masticatory apparatus and of the upper airways, orthodontist are in a strategic position to detect in their young patients developing disorders in these regions; accordingly when they suspect the existence of OSAS they should ask systematic and well targeted questions of parents who may not be aware of the relationship between certain symptoms their children display and sleep breathing problems. The goal of this article is to provide practitioners with a better understanding of the symptoms and the physio-pathological mechanics of OSAS so that they can spare their afflicted patients the complications it provokes by seeing that early treatment is undertaken.

Treatment teams use different approaches for correcting the alveolar cleft sector of labio-palatal clefts. Age of patient, whether or not bone grafts are used, and the type of bone grafted are some of the differences. Our team performs a gingivoperioplasty with a graft of iliac cancellous bone on patients 4 to 6 years old. This procedure is carried out within the framework of orthodontic treatment designed to restore transverse dimension pre-operatively with a quad helix and to retain the expansion with 6 months of retention. The gingivoperioplasty is accomplished in a zone free of any scar tissue that might have resulted from a primary cheiloplasty followed by closure of the palatal cleft. In our view all teams must eventually utilize cone beam X-rays for their radiographic evaluations because they are the only tool that provides results of objective analysis that are of high quality and have demanded a very low level of radiation.

The objective of this article is to offer a simplified and reasonable approach for periodontal disease screening that should be a mandatory part of each and every oral examination. The main purpose of this examination is to answer the question of whether or not there are any infection sites that require periodontal management. This assessment has three parts: the initial patient interview (medical history), the clinical oral examination and the radiological examination. Using a periodontal probe, the dentist should place a high priority on performing PD screening and it should be done systematically and routinely during every consultation. Orthodontists and dentists are both licensed to perform this examination. After this examination, the practitioner can make a diagnosis, initiate periodontal management of the patient or refer the patient to an appropriate specialist.

PD screening should be repeated before orthodontic treatment or before any functional rehabilitation in order to maintain periodontal stability.

Over the past decade, the interest for miniscrews is continuously growing as confirmed by the amount of recent published studies. In particular, their use allows to make corrections in a single phase and avoids extractions of premolars, while keeping usual goals of treatment. Main results of pilot studies and some clinical examples are presented here to illustrate our therapeutic approach for the treatment of tooth discrepancy in Class I, Class II and Class III situations.

The exchange of position of two adjacent teeth constitutes a transposition. Maxillary canines are rarely affected; transpositions of upper canines occur in only .2% of the orthodontic population. They can be detected early in radiographic examinations and later, clinically, after they begin to erupt. Most writers affirm that transpositions, which are often associated with other dental anomalies, are caused primarily by some genetic defect but that local factors may contribute to their development. Practitioners should consider their muco-gingiva environment as an important factor in their evaluation of the iatrogenic risks that might accompany treatment and consider improving soft tissue status as a preparatory soft tissue therapeutic procedure. They must also differentiate between cases of incomplete transposition and partial complete transposition, which can almost always be successfully treated, from cases of total complete transposition that are relatively difficult if not impossible to treat.

For many years TREFLE, The Ecully team treating labio-palatal clefts, has begun managing the care of patients with clefts at younger and younger ages. Both surgically and orthodontically we design our therapeutic interventions to change the environment of the cleft as rapidly as possible in order to improve patients’ functioning that will in turn have a beneficial effect on growth and esthetics. We have found that our patients treated in this way not only have improved appearance but also less likelihood of needing orthognathic surgery. We have also found that our patients do not routinely require early bone grafts, at about 6 years of age. We determine which children will require this intervention in a re-evaluation that we undertake after the completion of the primary phase of orthopedic and orthodontic therapy.

To make our technique as clear as possible throughout the course of this article we present the different stages of treatment of four children, Leslie, Jules, Nathan, and Élodie.

In this paper we examine the placement of the human canine tooth in the dento-alveolar system in order to explain its phylogenesis and ontogenesis over the course of its interactions with other tissues. We explain the known genetic mechanisms that occur throughout its morphogenesis and during its eruption until the tooth takes its place in the oral cavity. We carefully examine the role that genetic and environmental factors play in causing anomalies in its form, maturation, eruption and function.

We show how environmental factors determine how well it becomes integrated into the already established dental functional schema.

Any attentive observer of families who have a child afflicted with a cleft lip whether or not associated with a palatal cleft would be certain to be impressed by the importance of the psychological context of their interpersonal exchanges and the risks of a breakdown in the parent-child relationship adversely affecting the child’s development. The birth of a child with a cleft lip inevitably becomes a painfully stressful and traumatic event for its parents.

In the framework of the Programme Hospitalier de Recherche Clinique (PHRC) we have evaluated the psychological perceptions of parents of cleft lip and palate patients during the child’s first year of life in a multi-disciplinary and multi-group prospective study. Our goal is to analyze both the child’s psychic suffering and the parent-child relationship. We compared the results obtained in four hospital centers using different surgical protocols, distinguishing between the sub-groups of parents who had learned of the defect from an in utero examination and parents who did not become aware of the cleft until the child was born.

We analyze for the parents the psychic and psychological dimensions of the deformity and its correction, touching on the importance of a prenatal diagnosis, the development of a relationship with the child, self-images, and the quality of life as well focusing on the infant’s distress and eventual recovery from it. The results of this study should make it possible for health care workers to construct new ways of attenuating, insofar as possible, the psychological impact of the deformity on parents and their children and to improve long term care for these patients.

The aim of this study was to observe the effects of treatment with a Trainer T4K® myofunc tional appliance of thirteen late mixed dentition patients. We conducted thorough clinical examinations that included assessment of breathing and swallowing capabilities and took profile cephalograms and study models for each one. We also selected a control group that had been treated only with palatal expansion so that we could distinguish the effects of myofunctional therapy from those of expansion. We observed significant mandibular growth (p<0.05) of 3.24 mm on the average and a significant decrease in overjet, essentially linked to dento-alveolar effects, in the Trainer T4K® group. Swallowing and breathing function also improved in these patients. The two groups had similar maxillary and mandibular expansion.

So we conclude that use of a Trainer T4K® myofunctional appliance results in improved antero-postero dental relationships and an improvement in oral functioning.

At one time or another all orthodontists have to deal with a patient in their daily practice who sufferers from a temporo-mandibular disorder. Usually not well trained in this area they avoid the problem by referring the patient to an ‘‘occlusodontist’’ even though the majority of these TMD problems can be resolved by simple non-invasive techniques that any dentist can readily perform.

In this article I describe the therapeutic sequence of events. When pain is present, practitioners devote the initial appointment to establishing a diagnosis of ‘‘painful disorder.’’ At the same time they must explain to their patients what the different psychosocial components of the TMD are. While the clinical examination practitioners conduct next is simple and speedily completed, its correct execution requires a certain apprenticeship. The result of properly concluded procedures is a precise diagnosis of the functional TMD problem.

Then I review the wide range of therapeutic possibilities that are currently available, which are comparable to those employed in medical rheumatology.

Finally, I present the treatment of a patient with TMD to illustrate the clinical application of this up-to-date approach.

1 –The word "orthodontics". In 1841, Lefoulon suggested the term "orthodontosie," which the Americans simplified to "orthodontia" and, later, to "orthodontics". But the French resisted. A long struggle began between"orthopedics" and "orthodontics, " which wound up in 2007 with "orthognathodontics". Have we reached a truce?

2 – The word "malocclusion". E. Angle decided that the word "irregularity" employed in the 19th century was inappropriate. He proposed the term "malocclusion", which the French for a long time denigrated only to begin to employ it recently. But beneath new vocables new concepts are hidden.

In this article we describe a method for maintaining periodontal health that we have used in a quasi-systematic fashion in our orthodontie treatment of patients with chronic Periodontitis. Taking charge of their periodontal care and stabilizing their teeth are obligatory first steps in their orthodontic therapy. Then we ask them to initiate careful brushing by mechanical or sonic techniques.

During the course of orthodontic treatment these adult patients have routine monthly visits for essential periodontal therapy that consists of plaque removal and smoothing of the root surfaces of all teeth and implants with Vector Pro® and its carbon and composite inserts associated with hydroxylapatite and hydrogen peroxide. These monthly visits for periodontal care together with mechanical or sonic tooth brushing at home have effectively contributed to the long term stability of our results, from both orthodontic and periodontal perspectives.