The number of patients diagnosed with and treated for obstructive sleep apnea syndrome (SAHOS) is steadily increasing. Continuous positive airway pressure ventilation (CPAP) remains the reference treatment for severe SAHOS (AHI > 30/H). This treatment is not always well tolerated or accepted over the long term. To address this issue, alternative treatments are being developed, and among them, facial skeletal surgery (“bimaxillary”) remains one of the most effective.
Maxillary expansion using bone-screw anchorage rests on the remarkable plasticity of the intermaxillary suture in children, but its progressive closure after puberty often requires a surgical approach for effective expansion. The introduction of palatal bone anchors has redefined traditional indications, making a rigorous assessment necessary to optimize control of the transverse dimension. We will outline the selection criteria, the crucial contribution of 3D imaging (CBCT) for precise planning, as well as the fundamental principles for implementing disjunction on osseous support, to optimize outcomes.
Obstructive sleep apnea is a condition that involves a multitude of specialties.
Due to its location (soft tissues of the neck), the ENT (otolaryngology) field plays a major role in its diagnosis and treatment.
In this presentation, we will review the role of ENT specialists, what can be done from the consultation, and how we communicate and work with the other specialties.
Between the orthodontist and the surgeon, it’s an old story of a couple. We see each other, we write to each other, we complement each other, but do we truly understand one another?
I had the intuition that no. That there were areas of uncertainty, things left unsaid. So, to clear up this fog, I decided to cross the line. Literally, to go to the other side of the wall.
I questioned ten maxillofacial surgeons. I didn’t want textbook answers; I was looking for their truth: >How do they see our cooperation?
>What do they expect from us? But also who does what?
And finally, our two monologues become a real dialogue.
The All-in-Five treatment protocol represents a simplified and biologically efficient orthodontic strategy, designed to achieve predictable correction of Class II and Class III malocclusions in a limited number of clinical appointments. Based on the principles of Sagittal First biomechanics, this protocol prioritizes early correction of the anteroposterior disharmony before proceeding to alignment and finishing phases.
Class III malocclusion cases caused by excessive mandibular growth, associated with facial asymmetry due to mandibular deviation, remain a major challenge in orthodontic treatments.
This lecture presents a technique aimed at improving this situation to an acceptable level, avoiding the surgical approach.
The MEAW-GEAW technique (multiloop edgewise arch wire and Gummetal edgewise arch wire) is used here to induce clockwise mandibular rotation and restore balance of mandibular position.
Two clinical cases of adolescent patients with Class II malocclusions associated with facial asymmetries using this technique will be presented.
Standardize surgical preparation with splints: a reliable and reproducible protocol enabling rapid achievement of occlusion.
By controlling the post-surgical occlusal plane with this protocol, the risks of relapse can be managed.
Orthognathic treatment is a key factor for managing skeletal disharmonies, improving facial aesthetics and functional occlusion through correction of maxillary morphology.
Progress in diagnostic accuracy and in biomechanics has broadened the scope of orthodontic treatment alone.
This presentation outlines the current limitations of non-surgical treatments and their implications within a contemporary treatment plan.
Maxillary expansion using bone-screw anchorage rests on the remarkable plasticity of the intermaxillary suture in children, but its progressive closure after puberty often requires a surgical approach for effective expansion. The introduction of palatal bone anchors has redefined traditional indications, making a rigorous assessment necessary to optimize control of the transverse dimension. We will outline the selection criteria, the crucial contribution of 3D imaging (CBCT) for precise planning, as well as the fundamental principles for implementing disjunction on osseous support, to optimize outcomes.
Orthognathic surgery is in perpetual evolution. An evolution first driven by the aggressiveness of social networks—those of patients’ forums and those of surgeons who display their results. Often, the image becomes the only support for the outcome and reduces discussion to the morphological or aesthetic change perceived by some and requested by others, with a mutual understanding that is often limited. It is a pity—and probably harmful—because this result is by far the least predictable. In this context, cephalometrics is dead, and Jean Delaire too, in fact, along with the architectural analysis that was his. But two points remain and can be measured: occlusal stability—skeletal and dento-alveolar—and functional balance, articular, respiratory, masticatory, and even postural. Around this subject, the age at which surgery is performed, residual growth, and the risk of relapse are still debated. We have chosen the path of increasingly early surgery, and we will try to clarify the reasons for it.
Dès lors, l’autre évolution de la chirurgie orthognathique est purement quantitative. Plus de demande, plus de chirurgiens formés, plus de confiance dans la relation orthodontiste-chirurgien, plus de vulgarisation de l’information. Et cette évolution est aussi portée par des points techniques, la planification tridimensionnelle, la chirurgie guidée ou personnalisée, la RAAC ou récupération accélérée après chirurgie, la chirurgie mini-invasive… Reste la standardisation des techniques qui pourraient finir par nourrir l’apprentissage profond d’une intelligence artificielle. Il y a fort à penser que ceci ne tardera pas. Mais nos patients garderont leur singularité et l’échange et la discussion resteront la base de notre travail. En tout cas je l’espère.
Lingual orthodontics emerged in the 1970s in the United States and Japan; initially reserved for a few pioneers, its use expanded widely to mainstream orthodontic practices in the 2000s with the arrival of fully individualized systems that made treatment management easier and enabled the achievement of high-quality therapeutic results.
During this conference, we will examine through clinical cases the specificities of orthodontic preparation in lingual technique in surgical cases, the finishing and retention phase. Lastly, we will answer the question: are there any contraindications to the use of lingual orthodontics in orthodontic-surgical cases?
Most Class III malocclusions are usually considered « surgical » as soon as they are out of reach of orthopedic or orthodontic treatment.
But what kind of orthopedics are we talking about? Is it early orthopedics or late orthopedics, for example using Bollard plates?
And does the phrase « out of reach » mean that treatment objectives are unattainable? If so, for what reasons?
By attempting to answer these questions, we are led to look into the functional nature of Class III malocclusions and the systemic approach to correcting them.
This line of thinking leads to proposing a preferential treatment and posits that the rehabilitation of mastication would be a natural device for consolidating corrections, whether
orthopedic, orthodontic, or even surgical.
Orthognathic surgery and orthodontics are not only interventions
biomechanical. They represent a profound modulation of the oro-facial sphere, with measurable neurosensory and psycho-social repercussions. For younger generations, who are rushed and concerned about their image, this transformation is not simply a correction, but a reconciliation between the perceived self-image and the projected self-image.
The literature shows that care leads to a significant improvement in health-related quality of life, with gains in self-esteem and social integration.
In short, redesigning the maxillofacial architecture also means reconfiguring the interface with the
world.
Bibliography
Chardat C (2013). Adolescence and aesthetics: psycho-odontological aspects. Bordeaux thesis
Mary G (2016). Congenital facial malformation during adolescence: the psychological stakes of reparative surgery. Human medicine and pathology. Medical thesis, Paris Descartes University
Benkimoun F (2021). https://labimaxbox.fr/blogs/news/laspect-psychologique-de-loperation-des-machoires-
interview of a orthodontist-psychotherapist
Jourdan C, Revol O (2024). Our children’s brains in the face of the challenge of digital technology. Sauramp Médical.
Revol O, Sixt O (2024). La Génération Alpha. Réalités Pédiatriques. December 2024
Cymes M, Revol O (2026) : Heureux comme des TDAH ! Albin Michel, 228 p.
We provide an overview of the different options currently available to treat Class III skeletal malocclusions, thanks to new orthopedic techniques combined with skeletal anchorage and the most advanced compensation treatments, both with fixed appliances and with aligners.
We will place particular emphasis on the key elements enabling a NON-surgical treatment to exceed the patient’s expectations.
Choosing between surgical or non-surgical treatment requires decision-making that goes beyond simple skeletal diagnosis, taking into account the patient’s opinion and the circumstances of life.
This lecture presents a patient whose treatment can be carried out using both options. The key factors influencing the decision (aesthetics, functions, invasive technique, duration, and social context) are assessed. Through this clinical case, we address the diagnostic data and the social context to determine a therapeutic strategy.
Orthodontics and Periodontics: Allies or Adversaries?
Orthodontics plays a key role in periodontal health, with effects that are often beneficial but sometimes harmful. It can, for example, improve oral hygiene by correcting malpositions, or restore function following secondary migrations—frequent consequences of periodontal diseases.However, uncontrolled tooth movements or unsuitable splinting can lead to gingival recessions and periodontal complications.A multidisciplinary approach is essential to maximize benefits while minimizing risks to the supporting tissues of the teeth.
SQODF & consultant in a design firm specializing in the low-carbon transition
Towards a low-carbon practice: issues and solutions
Where do our impacts come from, and what are our action levers in the short, medium and long term? This presentation, designed as a discussion between Dr Pastwa and Dr Oosthoek, will aim to inform thinking on decarbonizing our activities, and more broadly on what the transition to a more sustainable practice involves.
Doctor of Dental Surgery – Specialist in Dentofacial Orthopedics – Former Intern of the Hospices Civils de Lyon – DU in Medical Law – Faculty of Law, University of Lorraine
1. Moving toward environmental responsibility in the practice: issues / solutions (joint lecture with Dr Justin Oostoek
In the face of the climate challenge, the general dental practitioner and specialist must incorporate into their day-to-day practice measures aimed at reducing the environmental impact of their practice. However, there is little data on the issues involved in the ecological transition in dentistry.
2. Debonding orthodontic attachments and integrity of the enamel surface
The objective of a debonding protocol is to ensure complete removal of composite resin without damaging the enamel surface. A systematic review was conducted to analyze the impact of orthodontic debonding on the enamel surface.
Tomorrow’s orthodontics / fixed therapy vs aligner splints
How to involve your patients in an eco-responsible approach to help understand your environmental impact
The practice of our orthodontic profession has a significant environmental impact.
Practicing while overlooking this aspect is hardly acceptable today, and the whole value of this conference is to propose and explain a reproducible ecological project, allowing this impact to be minimized while involving both your team and your patients.
Educational Director of the “Diplôme Universitaire de Médecine Environnementale” (DUME), CHU Henri Mondor, Faculty of Medicine, Paris/Créteil.
Endocrine disruptors: what risks to health
Academic teaching coordinator in the Department of Conservative Dentistry – Endodontics at the Faculty of Dental Surgery in Strasbourg
-Educational coordinator of the DU in Smile Aesthetics from Strasbourg
How to treat leukoses or white spots
Aesthetic requirements are increasing, particularly at the end of orthodontic treatment.
Our patients find it difficult to accept shape, color, or symmetry disharmonies after spending many months, or even years, with the orthodontist.
Preservative dentistry, based on adhesion, makes it possible to effectively address these end-of-treatment concerns by adapting to the patient’s age.
This cosmetic dentistry is now established as a genuine aid to finishing orthodontic treatments thanks to techniques such as injected composites, veneers, cantilever bridges, infiltration of spots through erosion, whitening, etc.
This lecture aims to explain, through numerous clinical videos, the contribution of these aesthetic preservative techniques to finishing orthodontic treatments.
