[A perspective on the use of bone anchorage as opposed to other types of anchorage techniques]. / Mise en perspective de l'utilisation des ancrages osseux par rapport aux autres techniques d'ancrage.

INTRODUCTION: To convert our objectives into the desired treatment results, we need to control our mechanics and thus the anchorage used by avoiding any unwanted movements. It now seems unthinkable, at the dawn of the 21st century, to ignore the useful contribution of orthodontic screw-borne anchorage. Nevertheless, we are entitled to raise a number of legitimate questions. Do these forms of anchorage offer an alternative to all types of mechanics? Will they permit us to manage clinical situations which are beyond the scope of a more classical approach? Can they enhance the quality of our treatments? MATERIALS AND METHODS: Each of the authors describes clinical situations using screw-borne anchorage and compares with a conventional approach in order to make a non-exhaustive analysis of the mechanics applied, in their own office, and then highlights the most effective technique. RESULTS: With 15 years experience in the use of miniscrews, orthodontists have now adopted them with their many advantages as an integral item in their therapeutic armamentarium. However, treatment plans must be coherent. Our mechanics must be well thought-out and represent a cogent entity under the control of the practitioner. Creating screw-borne anchorage demands total control over anchorage stability.

The time needed to refit an orthodontic wire: influence of the attachments.

In this prospective clinical study, we assessed the relative speed with which archwires can be changed by comparing self-ligating brackets with classical methods using elastomeric and metal ties, as well as the impact of the stage of orthodontic treatment. The main judgement criterion was the time required to place orthodontic archwires with different cross-sections, alloys and compositions, using two types of brackets, conventional twin-tie and self-ligating. Placement time was recorded 10 times for each procedure by three operators experienced in the use of self-ligating bracket clips. The In-Ovation self-ligating bracket in the metal version (In-Ovation R) and its ceramic variant (In-Ovation C) has a shorter implementation (archwire removal and placement) time than a classical system (conventional MicroArch(®) bracket). Mean ligating time is halved with the In-Ovation self-ligating brackets versus elastomeric ties and is reduced four-fold versus metal ties (with the help of an assistant) and even six-fold versus metal ties placed unassisted. On average, the time-saving was 1.5 minutes per patient for ligating times ranging from 1.5 to 6 minutes. The time saved in this way at each session could be used easily and intelligently to improve patient hygiene, talk with the child about his/her treatment progress and improve communication with parents.