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.

Different surgical and non-surgical techniques have been developed in order to reduce the duration of orthodontic treatment. Regarding surgical techniques, corticotomies are widely used. The micro-osteoperforation technique (MOP), in addition to the piezocision technique, have been developed to provide minimally invasive surgery as an alternative to conventional corticotomies, without the elevation of a mucoperiosteal flap. Regarding non-surgical techniques, the approach is radically different in terms of physical stimuli or chemical techniques. Corticotomy and piezocision techniques have been found to be effective in accelerating orthodontic tooth movement, although the corticotomy technique presents a significant risk of postoperative treatment. These two techniques also offer the possibility of adding a bone graft using a tunneling surgical approach. Regarding non-surgical techniques, physical stimuli techniques such as with a laser are easy to perform, non-invasive and seem to be promising. However, their effectiveness has not yet been demonstrated, as is the case for chemical techniques. While at first glance these techniques are reassuringly non-invasive, do they not give the sensation of playing the sorcerer's apprentice ? Although surgical techniques seem to have demonstrated their significant efficacy in accelerating orthodontic tooth movement, non-surgical techniques do not yet provide a sufficient level of evidence and / or safety to be performed in our routine clinical practice as orthodontists. As these topics are innovative, new and future scientific evidence should be able to lead to the development of all these concepts.

The aesthetic and functional success of mandibular advancement surgery often depends on the quality of the orthodontic preparation that preceded it. In order to be optimal, this preparation must try to reproduce a class II malocclusion equivalent to the sagittal skeletal discrepancy, to allow a surgical procedure of sufficient amplitude. The aim of this article is to present, thanks to a clinical case, a new mandibular posterior anchorage device, called Abalakov, used in the context of these preparations. The modalities of placement and use of this simple osteosynthesis wire, placed in the anterior part of the ramus, are exposed step by step, until the final result is obtained. The advantages and effectiveness of the technique are then discussed and compared with other treatment alternatives. It can be concluded that this new device is a simple, comfortable, inexpensive and above all reproducible and highly effective means of distalization of the mandibular arch, with clear uprighting of the incisors.

For Helm, "the rhythm of facial growth often governs the course of orthodontic treatment". The moment of treatment is an important dimension for our therapy to last a minimum of time with a greatest chance of success and stability. This notion of processing time is a daily requirement in our practices. The radiographs of the wrists will gradually disappear according to the ALARA principle, since we can in a single irradiation, via the profile radiography, have sufficient information to situate the patient on its growth curve. The vertebral stages are good biological indicators of individual skeletal maturity but their interpretation remains difficult. In this work, a computerized method was used to determine the stage of vertebral maturation in a reliable and reproducible manner. In this study, 15young boys and 15young girls (total 30patients) were included, 12,2years old on average with a standard deviation of 2,6years. To determine the skeletal age of these patients, the practitioner made an hand-wrist x-ray and, for diagnostic reasons, he also made a profile radiography the same day. The patients who didn't made an hand-wrist x-ray were excluded. The vertebral computerized method seems to be a reliable method to be used in orthodontic practices. Other studies would allow to use this method for average ages, gender-appropriate.

The first publication on the use of magnets in dentistry for stabilizing prosthetics on implants dates back to 1953. Clinical development in orthodontics, without having experienced a real boom, has increased over the past ten years, in parallel with the improvement of the device. The objective of this review of the literature is to synthesize clinical applications and reported iatrogenic effects. A systematic review of the international literature from the Pubmed and Cochrane databases from 1999 to July 2018 was conducted which resulted in 36 articles. The factors studied are the indications and contraindications, the means or procedure, as well as the iatrogenic effects. Original cases are presented. The correction of infraclusions is the main indication, followed by the correction of anteroposterior malocclusions and then the correction of over-erupted teeth. Traction of an impacted teeth and diastema closure have not been found in recent publications probably because of the low benefit-risk ratio. The future no longer seems to be buried magnets or left in the long term in the mouth considering there seems to be concerns in terms of toxicity (or even the risk in terms of vital prognosis). The magnets could offer interesting perspectives to manage the current limits of the aligners, the movements of anterior egression, rotation and previous torque being still problematic...

The aim of this systematic review and meta-analysis was to compare self-ligating brackets (SLBs) considered as a whole to conventional brackets (CBs). An electronic search was performed in three databases (PubMed, MEDLINE via Web of Science, Cochrane Library) from their origin up to June 2017. Additional articles were hand searched from January 2006 to June 2017. This meta-analysis was restricted to randomized controlled trials (RCTs) and split mouth design studies (SMDs). No distinction was made between active and passive SLBs. The following variables were investigated: treatment duration, number of visits, alignment rate, rate of space closure, perception of discomfort during the initial phase of treatment, pain experience during wire insertion or removal, bond failure rate, time to ligate in or to untie an archwire, periodontal indices, occlusal outcomes, transverse arch dimensional changes and root resorption. 25 RCTs and 9 SMDs were finally selected. It was more painful to insert or remove a 0.019× 0.025 SS archwire in/from SLBs. It was significantly quicker to insert or remove an archwire from SLBs. There was less bleeding on probing with SLBs 4 or 5 weeks after bonding. All other variables did not exhibit any significant difference between SLBs and CBs. Out of the 31 comparisons between self-ligating and conventional brackets, 9 only revealed statistically significant differences. This meta-analysis contradicts most of the promotional statements put forward by the distributors.

This study is aimed at evaluating the Oral Health Related Quality of Life (OHRQoL) in adolescents aged 11-14 years-old during orthodontic therapy and 18 months after the start of treatment and the possible role of psychological parameters. Sixty patients were recruited, and data were collected using self-administrated questionnaires and intraoral clinical examinations. The questionnaires included sociodemographic characteristics (age, gender), the Lebanese version of the Child Perception Questionnaire between 11 and 14 years CPQ11-14 to assess the OHRQoL, the Discrepancy Aesthetic Index (DAI) for malocclusion, and the Child Health Questionnaire «CHQ-CF87» to appraise Self-Esteem (SE) and Psychological Well-Being (PWB). The mean scores of CPQ11-14 and its four subdomains were significantly better for participants with high SE /PWB compared to those with low SE / PWB at baseline. These same scores improved significantly during orthodontic treatment (p <0.001). However, DAI was significantly better in patients with low self-esteem and psychological well-being. Our findings showed improvement in oral health perception and psychologic parameters during orthodontic treatment. Investigators should consider the need to control the psychological parameters of patients when assessing orthodontic treatment need and improvement in OHRQoL during orthodontic treatment.

Obstructive sleep disordered breathing (OSDB), in children and adolescents, need to be treated quite soon to avoid complications. A paediatrician, a sleep specialist, an orthodontist, an ENT and a myofunctional therapist will examine together the children with OSDB and determine the best personalised surgical and medical treatments for each of them. Only medical treatments are reviewed in this article. An international consensus recommended adenotonsillectomy as the first line therapy in young with OSDB. Usually adenotonsillectomy is combined with several important adjunctive medical treatments. Overweight and obesity frequent in adolescents, worsen OSDB and increase persistent OSDB after adenotonsillectomy. Weight loss is obtained by dietary restriction, physical activity, psychological support and sleep hygiene rules. Anti-inflammatory drugs (corticosteroids and leukotriene receptor antagonists) have shown their efficacy in children with moderate OSDB. Orthodontic treatments, rapid maxillary expansion or oral appliance, are used in selected patients according to their maxillo-facial disturbances in adjunction to adenotonsillectomy. Nasal CPAP is rarely useful except in severe OSDB specially in persistent OSDB after adenotonsillectomy. Finally, active or passive, myofunctional therapy is, according to some authors, an indispensable adjunct treatment to avoid persistent OSDB after adenotonsillectomy. These personalized medical treatments of OSDB are either administered jointly with adenotonsillectomy or in a hierarchal order.

Connected health is a growing field and can be viewed from different perspectives, particularly in sleep apnea syndrome. The purpose of this review is to show how all these aspects of connected health are already used in the management of sleep apnea syndrome (SAS) and its comorbidities. First, it can give patients a better understanding and a better assessment of their health. It also facilitates their healthcare by allowing them a greater role in their care pathway. For healthcare providers, connected health tools make it possible to set up new procedures for diagnosing and monitoring ambulatory patients, and for the making of joint decisions by health professionals and patients. Finally, for researchers, e-health generates massive amounts of data, thus facilitating the acquisition of knowledge in real life situations and the development of new methodologies for clinical studies that are faster, less expensive and just as reliable. All these considerations are already applicable in the field of sleep apnea, both for proposed treatments and for comorbidities management and for the patient's involvement in his/her care pathway.