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.

Requests for orthodontic treatment have changed over the last few years due to the influence of social discourse and the promotion of the ideal of a forever young and ‘‘perfect’’ body.

The esthetic nature of these requests, even if they have always been implied in any orthodontic consultation, has changed and recently esthetics has been increasingly emphasized by prospective patients.

One consequence of these urgent requests is that orthodontists are on a slippery slope to becoming service providers and they therefore run the risk of no longer being recognized as Health Professionals.

Another consequence is that we now have patients with a very different ‘‘profile’’ which we will attempt to define in this article.

We will discuss esthetic treatment requests and the respective problems for each of three orthodontic age groups (children, adolescents and adults). We will illustrate these problems with three specific clinical cases. And since we are not trained to either identify or successfully manage the problems associated with this type of request, each of us has had to come up with our own clinical response. However, once we are certain or even suspect that we are dealing with a patient at risk (we will define this later) for whom an orthodontic solution is not appropriate, we then have to overcome our own reservations and refer the patient to a mental health professional whose specialized care will make it possible for the patient to become clearer about esthetic requests.

In most cases after everything is resolved, we can then professionally and respectfully take on the management of the patient. By taking these precautions, we will conduct ourselves as Health Professionals who seriously assess both the somatic and psychological dimensions of our patients’ requests.

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.

Only competent centres are able to provide the full range of multi-disciplinary specialized therapies that cleft lip and palate rehabilitation requires. Despite some detail differences in conducting treatment, the agreed centres produced consensual treatment philosophy and observe equivalent therapeutic schemes. These sequences, to which orthodontics invariably contributes, are designed to favour the normal outcome of facial development and functions.

Beginning early in mixed dentition, orthodontic rehabilitation is designed to afford patients good dental occlusion through orthopaedic and orthodontic therapies. At the end of the growth period, orthodontics prepares for eventual final surgical and prosthetic repair.

We avoid extraction of permanent teeth as an adjunct to treatment because it has deleterious effect on final skeletal harmony. We prefer basic appliances for mechanical therapy, and after completion of active treatment, a prolonged retention. A trained orthodontist is able to complete the orthopaedic and orthodontic stages in cleft lip and palate repair if he fully understands and follows the general cleft lip and palate treatment scheme and effectively communicates with the competent rehabilitation team.

The objective of this article is to demonstrate the effectiveness of good cooperation between orthodontists and Ear, Nose, and Throat specialists because of the importance of freeing the upper airways from obstruction in order to achieve a good orthodontic result as well as the other side of the coin, the beneficial effect orthodontic treatment can have in stimulating a functional liberation of those airways when no mechanical blockage is present. The article will emphasize how important it is for orthodontists to understand and to be alert to the signs and symptoms that would indicate the need for an ENT evaluation.

Apical root resorption is one of the principal undesirable side effects associated with orthodontic treatment. It is provoked by a number of etiological causes, most often mechanical in nature and can be aggravated by biological factors that are not yet clearly understood. The objective of our study was to determine the influence of anomalies in dental organogenesis on the occurrence of root resorption. We analyzed the radiographs of maxillary incisors taken before and after treatment of 85 patients observed by the same practitioner. The results of our study suggest that patients with dental anomalies, anomalies of dental conformation, especially of the type of microdontia/thin root, have an increased risk of suffering from apical root resorption of maxillary central incisors during the course of orthodontic treatment.

The aim of this article is to present a precise periodontal terminology that orthodontists can use to clarify communication between orthodontists treatment and their patients. What’s mean periodontal issues that arise in adult orthodontic treatment, what the purpose of the discussion? In general terms we refer, of course, to mechano-therapy for adults and to the periodontal diseases that arise with this class of patients and to the treatment that is available for these maladies. Orthodontists who treat adult patients and record procedures in careful way need to rely upon a precise periodontal vocabulary so that, as group leaders, they can communicate effectively with other members of the inter-disciplinary treatment team as well as with patients. In the management of this effort, orthodontists are responsible for referring patients to periodontists when it’s necessary and for keeping the lines of communication open between patients, andperiodontists.

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.