L' Orthodontie francaise最新文献

{"title":"Dental agenesis: From molecular diagnosis to multidisciplinary management","authors":"Agnès Bloch-Zupan, Alexandra Jimenez-Armijo, Marzena Kawczynski","doi":"10.1684/orthodfr.2026.221","DOIUrl":"10.1684/orthodfr.2026.221","url":null,"abstract":"<p><strong>Introduction: </strong>Dental agenesis is the most common dental developmental anomaly. Its clinical presentation is highly heterogeneous, ranging from the isolated absence of one or more teeth to complex syndromic forms associated with ectodermal or craniofacial abnormalities. Etiological diagnosis, particularly genetic diagnosis, is now a key factor in understanding these anomalies and determining treatment.</p><p><strong>Materials and method: </strong>The diagnostic process is based on an integrated approach combining a detailed medical history, clinical and radiological examination, detailed analysis of the oral-dental phenotype, and referral for genetic testing. Data from next-generation sequencing (NGS) enable the identification of the genetic variants involved. This approach is implemented within specialized networks, in particular the O-Rares Reference Center for Rare Oral and Dental Diseases, a member of the TeteCou network, and European Reference Networks (ERN Cranio).</p><p><strong>Results: </strong>The integration of clinical, radiological, and molecular data improves diagnostic accuracy and distinguishes isolated forms from syndromic forms of dental agenesis. Genetic analyses thus contribute to identifying etiological mechanisms and better characterizing phenotypes. Clinical cases from expert centers illustrate the contribution of genetic sequencing to understanding anomalies and developing treatment plans.</p><p><strong>Discussion: </strong>The management of dental agenesis requires close collaboration between different specialties: orthodontists, general and specialist dentists, maxillofacial surgeons, pediatricians, geneticists, biologists, radiologists, and psychologists, among others. This multidisciplinary approach allows for the integration of diagnostic, therapeutic, and psychosocial dimensions. Molecular diagnosis also provides important information for prevention, genetic counseling, and follow-up of patients and their families.</p><p><strong>Conclusion: </strong>Advances in molecular genetics techniques and the organization of referral networks have greatly improved the diagnosis and management of dental agenesis. The multidisciplinary approach, combined with high-throughput sequencing tools, is now an essential lever for refining diagnosis, optimizing therapeutic strategy, and improving patient care.</p>","PeriodicalId":101415,"journal":{"name":"L' Orthodontie francaise","volume":"97 1","pages":"55-64"},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing dento-gingival harmony in achieving a balanced smile","authors":"Olivier Sorel","doi":"10.1684/orthodfr.2026.225","DOIUrl":"10.1684/orthodfr.2026.225","url":null,"abstract":"<p><strong>Introduction: </strong>Managing dento-gingival harmony in the balance of the smile requires a holistic approach: The harmony of a whole stems from the harmony of its parts.</p><p><strong>Materials and method: </strong>We conducted a search in the specialized PubMed database. The search focused on articles published after 2000, selecting those addressing the three topics that constitute the determinants of dento-gingival harmony in the balance of the smile: sociocultural influence, determinants of dento-gingival harmony, and iatrogenic risks.</p><p><strong>Results: </strong>The literature warns us of the fragility of dento-gingival harmony, both in terms of tooth enamel and periodontal tissue.</p><p><strong>Discussion: </strong>The maturation and aging of teeth and gums increase the risk of disrupting harmony and make treatment conditions more delicate. A multidisciplinary approach, along with a diagnosis and prognosis that take both teeth and gums into account, help ensure dento-gingival harmony.</p><p><strong>Conclusion: </strong>Dento-gingival harmony is a subtle goal. Seeking harmony means going beyond the overly superficial notion of aesthetics to work in depth on a balance that is always multifactorial.</p>","PeriodicalId":101415,"journal":{"name":"L' Orthodontie francaise","volume":"97 1","pages":"23-46"},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential diagnosis within primary molar retention: Characteristics of primary eruption failure versus primary retention of a single tooth","authors":"Beatriz Castañeda, Aline Lessa, Julie Galimand, Irina Giurgea, Marie Legendre, Frédéric Lézot","doi":"10.1684/orthodfr.2026.218","DOIUrl":"10.1684/orthodfr.2026.218","url":null,"abstract":"<p><strong>Introduction: </strong>While impaired eruption of permanent molars is a rare phenomenon, its prevalence appears to be increasing. Among these disorders, a distinction can be made between impactions, in which a tooth is blocked along its eruption path by a physical obstacle, and primary retention, in which eruption ceases in the absence of such a barrier. Within primary retention, primary failure of eruption (PFE) is a genetically determined condition that can severely affect one or more teeth and impact adjacent teeth. The clinical management of PFE is complex and multidisciplinary, and orthodontic traction is not recommended, as it often results in progressive ankylosis. Early identification of PFE is therefore essential to guide the therapeutic strategy.</p><p><strong>Materials and method: </strong>Clinical and genetic analyses were conducted in a cohort of patients presenting with primary molar retention. The objective was to propose clinical and radiological criteria to differentiate PFE from primary retention of a single tooth (PRST), in order to guide clinicians in treatment planning prior to genetic confirmation.</p><p><strong>Results: </strong>Thirty-four patients treated at the Orthodontics Department of La Pitié-Salpêtrière Hospital (Paris, France) were included. PFE cases were characterized by involvement of several teeth, posterior predominance with possible anterior involvement, posterior infraclusion, reduced alveolar bone height in the affected area, eruption arrest that typically occurred at the supra-crestal level, a positive family history, and an absent, abnormal, or pathological response to orthodontic treatment. PRST cases were characterized by involvement of a single tooth in a given area, predominantly posterior location, eruption arrest that most often occurred intraosseously, apical root curvature in contact with the cortical bone, absence of family history, no initial ankylosis, and a favorable response to orthodontic traction.</p><p><strong>Discussion: </strong>In patients with PFE, orthodontic treatment does not correct eruption but may in fact worsen the condition, notably by causing intrusion of adjacent teeth. In contrast, patients with PRST generally achieve gradual and effective eruption correction with orthodontic traction. Establishing precise clinical and radiological diagnostic criteria is therefore essential to avoid inappropriate treatment and to promptly refer patients to appropriate care, including genetic confirmation if necessary.</p>","PeriodicalId":101415,"journal":{"name":"L' Orthodontie francaise","volume":"97 1","pages":"47-54"},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysventilation, orthodontics, and orofacial myofunctional therapy","authors":"Philippe Amat, Yves Soyer","doi":"10.1684/orthodfr.2026.224","DOIUrl":"10.1684/orthodfr.2026.224","url":null,"abstract":"<p><strong>Introduction: </strong>Dysventilation is a chronic alteration of physiological ventilation patterns, characterized by a predominance of mouth or mouth-nose breathing at rest. It should not be considered a simple symptom, but rather a functional disorder in its own right, capable of disrupting facial morphogenesis and promoting neurocognitive disorders.</p><p><strong>Objective: </strong>Dysventilation is the cause of a dysmorpho-functional spiral. The aim of this article is to determine how its multidisciplinary management, particularly through orthodontics and orofacial myofunctional therapy (OMT), can help put children back on the path to harmonious growth and offer adults better oro-cranio-facial balance.</p><p><strong>Materials and method: </strong>A synthesis of published data on the morphological and functional consequences of dysventilation was performed. The conclusions of the data and recommendations concerning the organization and means of managing dysventilation and obstructive sleep apnea were reported. A clinical case is presented to illustrate the clinical management of dysventilation using the MyoSimple®, a new, patented myofunctional rehabilitation appliance featuring a specific tongue ramp.</p><p><strong>Results: </strong>The published data, even though of uneven methodological quality, seem to show the superiority of OMT combined with the use of a prefabricated functional appliance (PFA) compared to the implementation of OMT without PFA, particularly in the context of dysventilation management. A new approach to OMT, active and passive with PFA, which is more effective, simpler, and less time-consuming, is proposed. The MyoSimple®, a new patented prefabricated functional appliance, features a specific tongue ramp. Wearing it helps to promote tongue thrust, combined with clearing of the upper airways and promotes nasal breathing. A clinical case is presented to illustrate the clinical management of dysventilation.</p><p><strong>Conclusion: </strong>Dysventilation is the cause of a dysmorpho-functional spiral. Its management must always include a phase of OMT assisted by a PFA. This simple therapeutic approach helps to achieve better orofacial functional balance in the management of dysventilation and obstructive sleep apnea and contributes to the stability of the results of orthodontic treatments.</p>","PeriodicalId":101415,"journal":{"name":"L' Orthodontie francaise","volume":"97 1","pages":"101-119"},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infant ankyloglossia: Current data, scientific controversy, and medico-legal issues. A critical review of the literature","authors":"Yves Soyer, Philippe Amat","doi":"10.1684/orthodfr.2026.222","DOIUrl":"10.1684/orthodfr.2026.222","url":null,"abstract":"<p><strong>Introduction: </strong>Ankyloglossia is a congenital condition characterized by limited tongue mobility due to an abnormality of the lingual frenulum. Long considered benign, it is now the subject of growing interest, with an increase in diagnoses and neonatal frenotomies, amid controversy stemming from the heterogeneity of diagnostic criteria and the limited level of evidence regarding long-term benefits.</p><p><strong>Objective: </strong>The objective of this study is to critically analyze the embryological basis of ankyloglossia, its clinical implications, the indications for frenotomy, and the medico-legal issues associated with this procedure in infants.</p><p><strong>Materials and method: </strong>A critical narrative review of the international literature was conducted using major biomedical databases, including randomized trials, observational studies, meta-analyses, and institutional guidelines. Data analysis was performed using an integrative approach combining anatomy, pathophysiology, clinical findings, and ethical considerations.</p><p><strong>Results: </strong>The data suggest a short-term benefit of frenotomy, particularly regarding maternal pain and certain sucking parameters. However, evidence of a lasting effect on breastfeeding or the prevention of subsequent problems remains limited.</p><p><strong>Discussion: </strong>Interpretation of the results is limited by the heterogeneity of diagnostic criteria, variability in practices, and the small number of longitudinal studies. The increase in interventions raises a risk of overdiagnosis and overmedicalization, justifying an indication based on an objective functional impact and an approach consistent with evidence-based medicine.</p><p><strong>Conclusion: </strong>Neonatal frenotomy may be beneficial in the short term for selected indications, but it should not be performed routinely or prophylactically.</p>","PeriodicalId":101415,"journal":{"name":"L' Orthodontie francaise","volume":"97 1","pages":"65-87"},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smile-guided facial rejuvenation: Contributions of orthodontic analysis to cosmetic surgery of the lower third of the face—Proposal for a decisionmaking algorithm","authors":"Jean-Paul Meningaud","doi":"10.1684/orthodfr.2026.219","DOIUrl":"10.1684/orthodfr.2026.219","url":null,"abstract":"<p><strong>Introduction: </strong>Modern facial rejuvenation can no longer be limited to the \"facelift\": Perceived age is strongly influenced by the smile, incisor display, lip support, and the proportions of the lower third of the face. These parameters are shaped by orthodontics (especially clear aligners) as much as by aesthetic surgery. What are the orthodontic determinants of facial rejuvenation (smile/perioral region/lower third), and how can they be integrated into a surgical or medical-aesthetic rejuvenation strategy?</p><p><strong>Objective: </strong>The objective of this article is to propose a practical decision-making algorithm capable of determining in which cases orthodontics alone is sufficient and in which cases a combined orthodontic-facial rejuvenation strategy is more appropriate.</p><p><strong>Materials and method: </strong>A structured narrative review was conducted based on searches of the PubMed, Scopus, and Embase databases (1990-2025). Articles addressing smile aging, aligner predictability (torque, extrusion, rotations), facial aging anatomy (fat compartments/skeletal framework), and rejuvenation techniques (midface/lower third, perioral complex) were selected.</p><p><strong>Results: </strong>(1) Aging is associated with reduced maxillary incisor display and relatively increased mandibular incisor exposure, along with lip lengthening. (2) Clear aligners align and level effectively, but their accuracy varies depending on the type of movement, with extrusion and some torque/rotations remaining less clinically predictable. (3) Surgical and non-surgical rejuvenation strategies target both the \"container\" (skeletal structure) and the \"content\" (fat compartments/superficial muscular aponeurotic system [SMAS]), as well as the perioral complex, in order to restore proportions perceived as more youthful. A simple algorithm for co-planning orthodontic treatment and facial rejuvenation can identify clinical warning signs that justify a combined strategy (orthodontics combined with injectables, lipofilling, lip lift, or cervico-facial rejuvenation).</p><p><strong>Discussion: </strong>An orthodontist-friendly framework for facial rejuvenation relies on four levers: (1) incisor display (at rest/during speech/when smiling), (2) incisor torque and smile arc, (3) lip support (avoiding retraction with an \"aging-like\" effect), (4) vertical dimension of occlusion and lower-third height.</p><p><strong>Conclusion: </strong>Orthodontists are key partners in facial rejuvenation because they control major perioral aesthetic determinants. Shared planning (standardized photographs, dynamic smile analysis, and precise torque and lip-support objectives) improves the naturalness of outcomes and reduces aesthetic discrepancies.</p>","PeriodicalId":101415,"journal":{"name":"L' Orthodontie francaise","volume":"97 1","pages":"5-13"},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of aging on the mechanical properties of Graphy® orthodontic aligners: In vitro study","authors":"Pauline Ursat, Éric Ursat, Thibault Canceill, Romain Hockel, Bart Vande Vannet","doi":"10.1684/orthodfr.2026.220","DOIUrl":"10.1684/orthodfr.2026.220","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this experimental study is to analyze the effect of artificial saliva on the mechanical properties of the Tera Harz TC-85 material (Graphy®) at different time intervals: day 0, day 7, and day 14, in order to observe over time the force delivered and the deformation of the direct-printed 3D aligners.</p><p><strong>Materials and method: </strong>18 identical, Class I without DMD, Graphy® aligners were included in three groups (D0 unaged, D7, and D14) to undergo a continuous aging procedure in Fusayama/Meyer artificial saliva in a water bath at 37°C to reproduce the conditions of the oral cavity, before being placed on the traction bench with traction tests at D0, D7, and D14.</p><p><strong>Results: </strong>Deformation at D0 differed significantly (p < 0.001) from deformation at D7 and D14 in the incisors and molars.</p><p><strong>Conclusion: </strong>The stability of the mechanical properties of the Tera Harz TC-85 material (Graphy®) for direct 3D printing of aligners suggests that a weekly aligner replacement may be considered.</p>","PeriodicalId":101415,"journal":{"name":"L' Orthodontie francaise","volume":"97 1","pages":"15-22"},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporomandibular joint disorders in juvenile idiopathic arthritis and their treatments","authors":"Séverine Guillaume-Czitrom, Sandrine Chilloh","doi":"10.1684/orthodfr.2026.223","DOIUrl":"10.1684/orthodfr.2026.223","url":null,"abstract":"<p><strong>Introduction: </strong>Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease with unknown cause, affecting one child out of 2,000. In more than a third of cases, the temporomandibular joints (TMJs) are involved. TMJ arthritis may cause significant functional disorders such as pain, reduced mouth opening, and malocclusion, as well as permanent aesthetic issues involving facial deformity. The purpose of this article is to describe the diagnosis and treatment of these children.</p><p><strong>Materials and method: </strong>Based on a literature analysis of TMJ involvement in JIA and our own personal experience, we present the data obtained and the questions that remain.</p><p><strong>Results: </strong>Diagnosis of TMJ arthritis in JIA relies on clinical examination and MRI with injection. It is often made too late, when sequelae are already permanent, due to the asymptomatic nature of TMJ arthritis in many children and because deformities appear long after destructive lesions of one or both joints. Screening for TMJ inflammation in JIA should be routine. MRI with injection has been chosen as the best screening tool, but false positives are numerous. How to improve TMJ arthritis screening in JIA remains an unanswered question. Treatments of active TMJ arthritis are varied, including orthodontic procedures, maxillofacial surgery, and systemic therapies, but there is currently no unified strategy, and the use of intra-articular corticosteroid injections in children is increasingly being challenged.</p><p><strong>Discussion: </strong>Many aspects of the management of TMJ arthritis remain a matter of debate, from the early detection of inflammatory involvement of the TMJs, which may place the orthodontist on the front line, to the role of orthodontic and systemic treatments, as well as that of maxillofacial surgery.</p><p><strong>Conclusion: </strong>These unanswered questions could be addressed via a French multidisciplinary network involving orthodontists, maxillofacial surgeons, radiologists and pediatric rheumatologists.</p>","PeriodicalId":101415,"journal":{"name":"L' Orthodontie francaise","volume":"97 1","pages":"89-99"},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distalization using retro-tuberosity screws: Presentation of four clinical cases","authors":"Julien Strippoli, Victor Ackermann, Léo Simon, Lou Deon, Laurent Weiss","doi":"10.1684/orthodfr.2025.217","DOIUrl":"10.1684/orthodfr.2025.217","url":null,"abstract":"<p><strong>Introduction: </strong>To correct bilateral Class II malocclusions or Class II subdivisions, various therapeutic options are available to the orthodontist, depending on the patient and the amount of tooth movement required. Retro-tuberosity screws (RTSs) represent one such alternative; however, they remain poorly documented in the literature. The aim of this article is to present a series of cases managed using RTSs.</p><p><strong>Materials and method: </strong>Four cases treated with RTSs are presented.</p><p><strong>Discussion: </strong>RTSs enabled effective sequential distalization. Adverse effects were limited, except for the risk of vestibular-palatal angulation . Placement can be technically demanding and requires the absence of wisdom teeth. The failure rate seems comparable to that reported for the rest of the oral cavity if a 2 mm diameter screw is used.</p><p><strong>Conclusion: </strong>RTSs represent a relevant distalization option for the correction of Class II malocclusions or certain asymmetries in adults without third molars. To confirm their indications and limitations, randomized controlled trials need to be conducted.</p>","PeriodicalId":101415,"journal":{"name":"L' Orthodontie francaise","volume":"96 4","pages":"395-412"},"PeriodicalIF":0.0,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foreword. Innovations and new technologies in bonded orthodontic retainers: putting the different wires into perspective","authors":"Paul Boury, Michel Le Gall","doi":"10.1684/orthodfr.2025.215","DOIUrl":"10.1684/orthodfr.2025.215","url":null,"abstract":"<p><strong>Introduction: </strong>The choice of retainer wire is crucial to ensuring long-lasting orthodontic results. Beyond simple mechanical retention, it must meet specific requirements in terms of design, physical properties, and biocompatibility. To date, there is no consensus on the best material, and new generations of wires continue to emerge to address the limitations of existing systems.</p><p><strong>Objective: </strong>This article aims to describe and compare various types of retainer wires, whether they are shaped manually, such as Respond and Ortho-Flextech, or produced using a robotic process, such as Memotain, TMA Winnove Medical, or PolyEther-Ether-Keton (PEEK) wire.</p><p><strong>Materials and methods: </strong>The \"ideal wire\" should ensure a custom fit, appropriate mechanical properties, smooth surface quality, biocompatibility, durability, and acceptable aesthetics. Current options include chairside wires (Respond and Ortho-FlexTech), CAD/CAM or robot-made retainers (laser-cut NiTi Memotain and robot-bent TMA Winnove), and milled PEEK devices. Each option involves trade-offs: adaptability and flexibility versus rigidity and control; isotropy of round sections versus anisotropy of square sections; and added costs and logistical demands associated with digital workflows.</p><p><strong>Discussion: </strong>In multistranded wires, Young's modulus (E) corresponds to that of the base alloy; clinical stiffness depends instead on the effective EI (geometry, compaction, and inter-strand slip). Clinical success also relies heavily on bonding quality: thin, even resin layers and short spans between composite pads are as important as the wire itself. Overall performance therefore results from the synergy of wire, adhesive, and clinical technique.</p><p><strong>Conclusion: </strong>Future developments are likely to focus on increased robotization, adhesive optimization, and the use of high-performance polymers. However, no current solution can yet be considered flawless.</p>","PeriodicalId":101415,"journal":{"name":"L' Orthodontie francaise","volume":"96 4","pages":"353-365"},"PeriodicalIF":0.0,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}