[Orthodontics founded on "proof" or therapeutic decision making based on the literature]. / L'orthodontie fondée sur la "preuve" ou la decision thérapeutique basée sur la documentation.

Faced to an abundant literature and to various clinical situations, practitioners are nowadays invited to implement an evidence based approach. This methodology, initially developed in Canada in the 80's, is getting widely used and is perfectly suited for Orthodontics and particularly for the evaluation of interceptive treatments. It is defined as the conscentious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. This approach, which requires four different steps, will initially be presented. A methodological guide that allows to grade the evidence among different research protocols, will then be introduced. At the top of the hierarchy, randomized clinical trials have shown to be the best tools available to evaluate treatment efficiency. Different research designs are finally put forward to evaluate interceptive treatments.

Collagenase synthesis by cloned rabbit pulp cells--molecular and immunological identity of pulp cell and fibroblast enzyme.

Cultures of cloned rabbit pulp (RP) cells without stimulation produced collagenase of a concentration as high as reference rabbit skin fibroblast cultures which were stimulated with phorbol myristate acetate (PMA, 100 ng/ml). The RP cell collagenase was compared with reference fibroblast collagenase in Western blot analysis using monoclonal antibodies prepared against RP cell collagenase and a polyclonal antibody prepared against rabbit fibroblast collagenase. Both enzyme preparations revealed, with either antibody, identical bands of approximate molecular masses 57,000, 52,500, and 45,000. These antibody preparations variously inhibited RP cell collagenase activity. Intracellular collagenase in RP cells in culture was demonstrated by the indirect immunofluorescence antibody technique using polyclonal anti-fibroblast collagenase antibody. RNA samples from RP cells hybridized with rabbit fibroblast collagenase cDNA (clone H9) and showed a distinct band at 2.7 kb. Both control and PMA-stimulated RP cells and PMA-stimulated reference skin fibroblasts demonstrated strong cytoplasmic hybridization between H9 and collagenase mRNA. The results indicate that RP cell collagenase is identical to rabbit fibroblast collagenase, and that the RP cell line provides a useful in vitro reference system for the study of collagenolysis in the rabbit model.