Aesthetic optimization based on the « Therapeutic Gradient ». From the perspective of an orthodontist.
The continuity of the arches, objectified by frank proximal contacts between all the teeth, is an essential characteristic of occlusal normality. The presence of periodontal fibres, particularly transseptal, the mesial drift, the orientation and the direction of the occlusal forces contribute with other factors to the maintenance of this cohesion.
Any break in the continuity of the arches can result in the presence of more or less important, localized or generalized interdental spaces. In some situations, these have no impact on the health of dental structures and are perfectly well accepted by patients. On the other hand, in other cases, the spaces result from congenital or acquired pathological processes and are then detrimental to aesthetics and occlusal function.
Dentistry has several methods for the management of unwanted spaces. Among these we can cite prosthetic treatments (fixed or removable), aesthetic restorations with veneers, orthodontics, etc. However, it is rare that a specific method, used alone, can lead to satisfactory aesthetic and functional results.
This communication aims to show, through the presentation of a series of cases, the interest of an interdisciplinary approach based on the possibilities offered by technological advances in Odontology. She will also point the finger at many clinical situations where inappropriate therapeutic indications have been posed.
Papa Ibrahima NGOM is Full Professor at the Faculty of Medicine, Pharmacy and Dentistry of Cheikh Anta Diop University in Dakar.
He holds a University Diploma in Orthodontics (DUO) (Nantes, France) and a Certificate of Special Studies in Dento-Facial Orthopedics (ODF) (Clermont-Ferrand, France).
After the Doctorate in Odontological Sciences passed in Dakar, he obtained the Diploma of Habilitation to Direct Research (HDR) (Clermont-Ferrand, France).
Agrégé d’Orthodontie, he is author and co-author of more than 70 articles and international speaker (author of more than 40 conferences) and member of the reading committee of the Journal l’Orthodontie Française (official publication of the French Society of Orthodontics SFODF) and co-editor of the West African Journal of Orthodontics.