Severe orthopedic treatments and surgery are often proposed as the only therapeutic outcome for resolving mandibular prognathism and maxillary hypoplasias.

Inverted articulations can be detected very early in early childhood, as soon as the primary dentition emerges.
Many authors, including Miyama and Mc Namara1, have shown that in the absence of treatment, maxillary retrusion does not improve over time, whereas mandibular protrusion increases. Taken together, this always leads to worsening of the initial skeletal disharmony.

In general, parents realize quite early that there is a problem with their child’s jaws, and from that moment on, intervention is required.
A loss of vertical occlusal dimension due to bilateral posterior edentulism generates Class III intermaxillary relationships, as is often the case in the elderly, who nevertheless no longer have growth.

In a growing child, the increase in occlusal height, through over-elevation on the posterior teeth, will help slow mandibular advancement and promote maxillary growth.

Transverse maxillary osteodistraction associated with orthognathic surgery: new tools for one-stage surgery by P. LEYDER, G. WYCISK, J. QUILICHINI
Severe transverse maxillary deficits in adults are traditionally treated in two stages when they are associated with complete, sagittal and vertical dysmorphosis.

Transverse correction first takes place via surgical-assisted osteodistraction; then a second stage of surgical correction of the other spatial anomalies is performed.
The authors describe a technique that makes it possible to achieve transverse correction in a single stage through osteodistraction and complex maxillary and mandibular surgery.

For this purpose, two new tools are presented: sliding maxillary plates, and a modular distractor, with osseous or dental anchorage.
All the patients achieved consolidation, and we corrected the transverse deficit according to the preoperative set-up predictions. The distraction results were quantified on study models and/or on CT scans.

We present two patients operated on according to this new strategy.
This is an innovative approach that allows, in the three dimensions of space, a maxillomandibular dysmorphosis with endomaxillia to be positioned in a single operative stage.

Towards the disappearance of brackets? by J. PHILIPPE
Techniques based on the use of brackets are, rightly, considered the best of the mechanical orthodontic treatment techniques. This does not prevent them from having multiple drawbacks and, in particular, failing to ensure proper lingual intercuspidation. One may assume that, given the increasing demands of clinicians, these techniques will be replaced by devices specially adapted to each type of movement, and, to restore alignment and intercuspidation, by an elastopositioning method.

The PUL (Universal Light Propulsor): 10 years of use by 2 clinicians by A. FIRMIN-VINCENT, É. ALLOUCH
Designed in 1997 by Élie Callabe, orthodontist, and Jean-Charles Morin, orthodontic appliance maker, the PUL or Universal Light Propulsor was first presented in France in 2001, after four years of clinical and technical validations.
Originally used in the treatment of Class II, it has benefited from technical improvements that make it possible to correct sagittal, vertical, transverse, and functional aspects, which is why it is called the “4D Harmonizer”.

The PUL system enables a gentle, physiological propulsion that leaves a great range of movement to the TMJ and its meniscus in lateral excursion, but above all in retroposition thanks to the mandibular springs. Indeed, at each swallow (2,000 times per day), the condyle-meniscus couple can reposition itself in its glenoid cavity, thus preserving a functional TMJ, relieving ligament tension and reducing the risk of inflammation, for improved condylo-mandibular growth.