Aligners: review of their chemical components, recycling, mechanical properties and therapeutic needs - Part 1 / Aligneurs : mise en perspective de la composition chimique, du recyclage, des propriétés mécaniques et des besoins thérapeutiques ­ Partie 1.

Introduction: The aligner is a thermoformed plastic device composed of various chemical components: polyurethane, polyethylene terephthalate glycol, polypropylene… All these plastics must be sufficiently resistant to abrasion and translucent for aesthetic purposes, but their solubility to salivary enzymes, insertion-disinsertion fatigue and recyclability vary according to material. From an orthodontic point of view, they must facilitate tooth movement. However, their behavior differs from that of orthodontic archwires: their Young's modulus, resilience and unloading curve are distinct, resulting in mechanical properties that fall significantly below the orthodontic requirements of multi-bracket systems. Objective: The aim of this article was to review the chemical composition, recycling and mechanical properties of aligners, and to put them into perspective with therapeutic indications. Materials and Methods: Literature data were approximated to orthodontic needs. Results: Neither plastic nor direct printing can match the mechanical properties of our archwires or the procedures of a reliable vestibular multi-attachment appliance. Discussion: Aligners remain an interesting tool in targeted indications.

Introduction: L'aligneur est un dispositif en plastique thermoformé dont la composition chimique est diverse : polyuréthane, polyéthylène téréphtalate glycol, polypropylène… Tous ces plastiques doivent être suffisamment résistants à l'abrasion et translucides pour être esthétiques mais ils présentent une solubilité aux enzymes salivaires, une fatigue liée à l'insertion-désinsertion et une recyclabilité qui sont variables selon le matériau. D'un point de vue orthodontique, ils doivent permettre de déplacer les dents. Mais leur comportement ne ressemble pas à celui des arcs orthodontiques : leur module de Young, leur résilience et leur courbe de décharge en sont éloignés et confèrent des propriétés mécaniques très inférieures aux exigences orthodontiques des appareils multi-attaches. Objectif: L'objectif de l'article était de faire le point sur la composition chimique, le recyclage, les propriétés mécaniques des aligneurs et de les mettre en perspective avec les indications thérapeutiques. Matériel et méthode: Les données de la littérature sont approchées des besoins orthodontiques. Résultats: Ni le plastique, ni l'impression directe ne sont en capacité de rivaliser avec les propriétés mécaniques de nos arcs ou avec les procédures d'un appareil multi-attache vestibulaire fiables. Discussion: Les aligneurs restent un outil intéressant dans des indications ciblées.

[Failures regarding the treatment plan]. / Les échecs relatifs au plan de traitement.

Who has never had a treatment failure? Who has never regretted launching into a treatment plan? And who has never vowed to avoid falling again into the same trap? All of us, of course. Which simply allowed us to fall into other traps once we'd pulled ourselves out of our previous failures. And to start with, do we believe that a successful outcome means achieving a molar and canine bilateral Class I, a normal overjet and overbite, and centered and coinciding midlines? So, does that make any other kind of treatment plan a recipe for failure? In more realistic mode, we should consider a treatment plan a failure when we are unable to achieve the objectives we set ourselves at the beginning of treatment, due to a lack of realism, or excessive optimism...

Digital impression-taking: Fundamentals and benefits in orthodontics.

The digital era has burst into our offices in a big way. 3D camera technology has improved, enabling us to record our impressions and the occlusion in a digital format file. This file can then be used to make set-ups and manufacture orthodontic devices. Like any new technology, it needs to be studied and understood in order to grasp it fully and master the information and digital flow which can be generated between one's office and any external party involved in treatment, such as laboratories or other colleagues.

European College of Orthodontics: commission of affiliation and titularisation.

Date of birth: 18/08/1992; sex: female. A PRETREATMENT RECORDS: (17 y 4 m; 17/12/2009). DIAGNOSIS: Angle Class II division 2 (deep bite and maxillary lingual incisor tipping) left subdivision with mandibular retrusion in a hypodivergent facial pattern. Teeth missing prior to treatment: none. TREATMENT PLAN: Correction of the Class II, 2 occlusal anomalies. Appliances and devices: bimaxillary lingual multibracket apliances. TREATMENT COMMENCED: 17 y 6 m; 16/02/2010. B POST-TREATMENT RECORDS: 20 y; 9/2012. DURATION OF ACTIVE TREATMENT: 31 months. END OF TREATMENT: 10/2012. C POSTRETENTION RECORDS: (1 year minimum): 21 y 6m ; 3/2014. DURATION OF RETENTION: 18 months.

Smile esthetics: calculated beauty?

Esthetic demand from patients continues to increase. Consequently, the treatments we offer are moving towards more discreet or invisible techniques using lingual brackets in order to achieve harmonious, balanced results in line with our treatment goals. As orthodontists, we act upon relationships between teeth and bone. And the equilibrium they create impacts the entire face via the smile. A balanced smile is essential to an esthetic outcome and is governed by rules, which guide both the practitioner and patient. A smile can be described in terms of mathematical ratios and proportions but beauty cannot be calculated. For the smile to sit harmoniously within the face, we need to take into account facial proportions and the possibility of their being modified by our orthopedic appliances or by surgery.