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Proffitt et al. have described "effectiveness and efficiency" (E&E) as achieving desired results without wasting the orthodontist's and patients' time. In 1972, Archibald Cochrane published a monograph entitled "Effectiveness and Efficiency," which challenged the medical community to use medical protocols that were evidence-based. As a possible starting point for E&E, the orthodontist could consider an "Evidence-based clinical practice" (EBCP) model, which integrates the best research evidence with clinical expertise and patient values. This model considers scientific or evidence-based orthodontics (EBO) together with patient preferences and patient autonomy, clinical or patient circumstances, and clinical experience and judgment. In this paper, therefore, E&E will be discussed from an EBCP perspective which, for our purposes, includes relevant evidence but also our clinical experience and rationale. We will discuss: wire sequence; NiTi Wire types; space closure by sliding; canine retraction versus en masse retraction, 18" slot versus 22" slot, the Bidimensional System; self-ligating brackets (SL); vertical slot; economic aspects., (Copyright © 2015 CEO. Published by Elsevier Masson SAS. All rights reserved.)

A dentigerous cyst is an odontogenic lesion caused by the expansion of the follicle surrounding the crown of impacted, embedded or unerupted teeth. These cysts may cause destruction of the bone, displacement of adjacent teeth, resorption of their roots and prevent the eruption of cyst-associated permanent teeth. This paper discusses successful use of marsupialization combined with orthodontic treatment to treat cyst-associated impacted permanent teeth and to correct a class II open bite malocclusion., (Copyright © 2015 CEO. Published by Elsevier Masson SAS. All rights reserved.)

The aim of this paper is to document additional cases to an unconventional protocol published in 2009. In 9 patients, sites rendered edentulous by the presence of an impacted maxillary canine were treated with 12 implants placed through the impacted canines. In another patient, 3 implants were inserted in the mandible to rehabilitate a failing bridge. Implants were placed encroaching upon either the root or the crown. No postoperative pain was reported. Healing was uneventful in all but one patient; the latter underwent soft tissue infection 2 weeks after implant placement and was successfully treated. All implants were restored; no implant failed during the 1- to 8-year follow-up. Before implementing this protocol on a routine basis, more implants and a longer follow-up are required. However, it opens intriguing treatment possibilities. It also suggests that there is still room for shifting a well-anchored paradigm in dental implantology., (Copyright © 2015. Published by Elsevier Masson SAS.)

Skeletal asymmetry of the TMJ or maxillary arch is always associated with basicranium skeletal asymmetry and can become pathogenic for the development of masticatory function. What means do we dispose of in our everyday practice for early screening and treatment of these often little-known asymmetries? This is the focus of our article, which draws on over 10years' experience within our own practices. We have systematically applied the following ground-rules: (a) look for clinical signs of facial asymmetry well before eruption of the deciduous teeth, and when the deciduous teeth have erupted; (b) during extraoral examinations, apply a new diagnostic tool involving a tracing of the soft tissue axes of the ears in order to uncover patients at high risk of intertemporal asymmetry; (c) look for maxillary intra-arch asymmetry using an Orthogrille(®)-type measurement grid; (d) look for inter-arch asymmetries using the "cranial" laterality test. Then, still during the deciduous dentition phase, we initiate treatment. In this paper, we outline the use of symmetrization sectorial screws combined with unlocking sliding plates in order to correct intra-arch and inter-arch asymmetry. We conclude by outlining techniques to remedy canted occlusal plane using a modified Fränkel-type appliance., (Copyright © 2012 CEO. Published by Elsevier Masson SAS. All rights reserved.)

With a worldwide incidence of 1/750 live births, facial clefts rank as the second most frequent congenital malformation. The term "sequelae" is used here to designate the conditions, which follow and are the result of labial-alveolar-palatal clefts. Most sequelae stem in fact from primary treatment and not from the initial malformation. However, there is no consensus regarding a management protocol. Among the 201 European centers treating this type of malformation, 194 different protocols are used for unilateral facial clefts alone! Unfortunately, primary surgery can trigger a wide range of harmful repercussions. It is for this reason that secondary surgery is called for, generally after the adolescent growth spurt. The aim is to correct the damage done by primary surgery, which can affect the nose, lips, teeth and jaws and impact functions such as speech, breathing and swallowing, as well as morphological and psychological development. Nonetheless, the children concerned are sometimes lost to treatment only to re-emerge in adulthood, aware of the resultant defects and looking for facial esthetic improvement. The sequelae of labial-alveolar-palatal clefts take very different clinical forms according to whether the cleft has been treated or not and the type and timing of the procedures performed. The surgeon's experience will be paramount in the management of such cases, which draws heavily upon dento-maxillo-facial orthopedics. In this context, we intend, in this paper, to propose modalities for the management of labial-alveolar-palatal clefts supported by information currently available in the literature. Management of labial-alveolar-palatal clefts requires an interdisciplinary rather than the only multidisciplinary approach. The practitioner coordinating the management must, like an orchestra conductor, ensure both the rhythm and the tempo of the treatment. The rhythm will determine the choice of chronological protocol and the tempo will govern the timing and importance given to each of the specialists involved. Practices vary from country to country but the orthodontist may be called on to assume this responsibility., (Copyright © 2012. Published by Elsevier Masson SAS.)

With a worldwide incidence of 1/750 live births, facial clefts rank as the second most frequent congenital malformation. The term "sequelae" is used here to designate the conditions, which follow and are the result of labial-alveolar-palatal clefts. Most sequelae stem in fact from primary treatment and not from the initial malformation. However, there is no consensus regarding a management protocol. Among the 201 European centers treating this type of malformation, 194 different protocols are used for unilateral facial clefts alone! Unfortunately, primary surgery can trigger a wide range of harmful consequences. It is for this reason that secondary surgery is called for, generally after the adolescent growth spurt. The aim is to correct the damage done by primary surgery, which can affect the nose, lips, teeth and jaws and impact functions such as speech, breathing and swallowing, as well as morphological and psychological development. Nonetheless, the children concerned are sometimes lost to treatment only to re-emerge in adulthood, aware of the presence of the resultant defects and looking for facial esthetic improvement. The sequelae of labial-alveolar-palatal clefts can take on very different clinical forms according to whether the cleft has been treated or not and the type and timing of the procedures performed. The surgeon's experience will be paramount in the management of such cases, which draws heavily upon dento-maxillo-facial orthopedics. In this context, we intend, in this paper, to propose modalities for the management of labial-alveolar-palatal clefts supported by information currently available in the literature. Management of labial-alveolar-palatal clefts requires an interdisciplinary rather than a multi- or pluridisciplinary, approach. The practitioner coordinating the management must, like an orchestra conductor, ensure both the rhythm and the tempo of the treatment. The rhythm will determine the choice of chronological protocol and the tempo will govern the timing and importance given to each of the specialists involved. Practices vary from country to country but the orthodontist may be called on to assume this responsibility., (Copyright © 2012 CEO. Published by Elsevier Masson SAS. All rights reserved.)

The correction of transverse skeletal abnormalities occupies a special place in orthognathic surgery. Maxillofacial surgeons employ a variety of techniques, but treatment stability remains a common problem. This paper presents a range of therapeutic options with special emphasis on two little-known techniques for correcting transverse skeletal abnormalities: symphyseal distraction and mandibular constriction. These techniques are described and their indications discussed., (Copyright © 2012 CEO. Published by Elsevier Masson SAS. All rights reserved.)

With the introduction of electrically detachable coils in 1991 and later the results of the ISAT trial in 2002, endovascular approach became the primary treatment for cerebral aneurysms in many countries. The suboptimal quality of anatomical results and the relatively high rate of aneurysm recurrence after treatment still hamper an even more widespread of the technique. In this paper, we will make a review of the anatomical factors associated with poor anatomical results as well as technological developments aiming at improvement of aneurysm healing., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

The treatment of Angle Class II/2 malocclusion requires an understanding not only of the dental and maxillofacial features but also of the changes occurring with age in the dental relationships. This paper attempts to determine certain dental relationships in patients with Angle II/2 malocclusion and any changes that might occur with age. The study material included 96 lateral cephalometric X-rays of patients with Angle II/2 malocclusion, the youngest of whom was 7 years old and the eldest 35. Six cephalometric measurements were performed on every cephalometric X-ray. Statistical processing of data included one-variable analyses and correlations of two variables. Statistical one-variable analysis used methods from descriptive statistics. Methods of inferential statistics have been applied in order to revel statistical significance. The evaluation of the findings of this research study concluded that, in patients with Angle II/2 malocclusion, maxillary central incisors presented pronounced palatal tipping, which exacerbated significantly with age, while mandibular incisors displayed reduced labial tipping and projection, which significantly reduced with age. Furthermore, it was found that there was pronounced incisor overjet, which increased with age, due to increased protrusion of mandibular incisors., (Copyright © 2011 CEO. Published by Elsevier Masson SAS. All rights reserved.)

The presence of a gingival recession prior to orthodontic treatment is a real problem. Patients are concerned about losing their teeth but may also complain of their unpleasant appearance or root sensitivity in the exposed area. The orthodontist is not sure whether orthodontic treatment can be performed or whether the tooth movement will not aggravate the recession and whether periodontal surgery needs to be done before or after orthodontic treatment. The aim of this paper is to present recent data from the literature and several clinical situations in adults in order to submit a treatment sequence and clarify the role of different periodontal plastic surgery root coverage procedures., (Copyright © 2011 CEO. Published by Elsevier Masson SAS. All rights reserved.)

In orthodontics, as in medicine in general, there is always only one diagnosis. For a given diagnosis, several treatment solutions are available. While these are hard and fast rules, the techniques adopted by orthodontists can vary and yet remain effective, without placing constraints on the practitioner. The lingual technique, originally designed to meet the demands of adult patients for "invisibility" is now comparable or even superior in terms of precision to vestibular techniques. Three clinical Class III cases involving adults and three distinct treatment options are described in this paper., (Copyright © 2010 CEO. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: The Cochrane Collaboration is an international scientific not-for-profit organization the purpose of which is to produce and distribute systematic reviews of randomized clinical trials. The aim of this paper is to list the different existing Cochrane systematic reviews in the field of dentofacial orthopedics (DFO) and to analyse their main features., Material and Methods: The choice of Cochrane systematic reviews based on dentofacial orthopedics was made from the exhaustive list published by the Cochrane Oral Health Group., Results: A total of 12 systematic Cochrane reviews related to dentofacial orthopedics were listed. All concluded on the need to conduct randomized clinical trials using more appropriate methodologies and comprising larger samples. None of these systematic reviews offered clear proof supporting any one form of treatment or treatment modality., Discussion: Despite the lack of relevant conclusions in the still meagre number of Cochrane systematic reviews related to DFO, it is essential for orthodontists to regularly consult the reviews in the framework of their daily evidence-based orthodontic practice. This is true too for orthodontic researchers as clinical DFO research needs to be extended with the setting up of methodologically unquestionable randomized clinical trials. However, there exist alternatives to randomized clinical trials offering a lower level of proof but which are better suited to the field of dentofacial orthopedics., (Copyright © 2010. Published by Elsevier Masson SAS.)

This paper outlines the clinical advantages of the lingual straight wire technique using the Orapix digital system. With this technique, incisor brackets can be positioned very close to the lingual surfaces thus enabling enhanced three-dimensional control. The elimination of wire bends facilitates space closure and reduces chair time. Combining the high precision available with the system and the use of customized archwires, teeth are moved gradually towards the ideal position as defined on the virtual set-up by each user., (Copyright 2010. Published by Elsevier Masson SAS.)

Deinstitutionalization and decentralization in psychiatry have by now been the first items of the agenda for more than 30 years. A theory of social psychiatry with social rehabilitation and reintegration was the underlying basis for the activities which should make the change from mainly inpatients to community-based outpatients treatment possible. By means of the National Danish Psychiatric Case Register this paper shows how the process mostly has concentrated on the deinstitutionalization (or reinstitutionalization?) of the old long-stay psychiatric patients. A new but smaller group of long-stay patients has appeared in the statistics. The average age of this group is 40 years compared to the old long-stay patients' average age of 60 years. It is also shown that the readmission rate during the first year after the discharge following the hospitalization during which the schizophrenia diagnosis was given for the first time ever is almost unchanged (with a small increase) for both males and females. So, in Denmark it is on average between 45% and 50% for females and males respectively. A break down on these data on counties shows that the situation varies broadly from a little over 30% for the best (mainly rural counties) to a maximum of 54%. It seems as if social psychiatry in the Nordic countries mainly concentrate on social care and only to a less degree on network, employment and other basic rehabilitation and reintegrative social work. A basis for a successful social integrative work must be a treatment initiated as early as possible with an antipsychotic treatment and maximum of compliance.

Although the physiopathological mechanisms causing hemifacial spasm are not clearly understood, it is generally accepted that the causative factor is compression of the facial nerve at its root exit zone. In this paper we present seven cases of hemifacial spasm which were studied by dynamic CT scanning in the preoperative period, and treated with microvascular decompression. We suggest that CT scanning has considerable diagnostic value in disclosing the asymmetrical vascular formation causing root exit zone compression and that microvascular decompression should be the treatment of choice in this condition.