Human Resource Management in the dental office: the advent of scientific and adaptive Management

The professionalization of the “management” function in dental practices and especially in group practices and specialized dento-facial orthopedics has become a major challenge for their economic viability. However, most practitioners manage their care structure and team empirically and intuitively on the “patriarchal” model that has been in place for decades in human-sized businesses. Unilateral decision-making, omnipotence and authoritarianism are favored to the detriment of a more participative and delegative mode of management involving the firm’s human and active forces in its continuous improvement approach (Quality approach). The management of organizational change and the adoption of working methods inherited from scientific management are all the more important as the social and economic situation is increasingly undermining the dental industry.

Do orthodontic extractions have an impact on the cutaneous profile?

Orthodontic treatments can have an impact on the soft tissues and more particularly on the cutaneous profile. The aim of this work was to evaluate profile changes following orthodontic treatment. Material and methods: This study concerned 90 patients randomly selected in the orthodontic department of Monastir (Tunisia). Profile headfilms at the start and at the end of orthodontic treatment were compared using, as reference lines, the SN-7° plane and the orthogonal to SN-7° plane going through the S-point (POSN- 7°). The Student test was applied to evaluate the variations in the cephalometric measurements. The Pearson test was used to study the correlation between the horizontal tooth movements and facial profile changes. Results: We noted a significant decrease in the upper labral (Ls) (p=0.049) and lower labral (p=0.048) as well as a significant increase in the labio-mental angle (p=0.025) in patients treated with extractions of premolars. A positive correlation between the incisor movements and the reduction of the labial protrusion was observed. Conclusion: The results of this study have shown that the movements of the incisors consecutive to extractions can have tangible effects on the cutaneous profile. Further investigations should be carried out to highlight the relationship between tooth movement and soft tissue.

Unwanted tooth movement produced by the bonded retention wire : the “wire syndrome,” observations, theories, clinical consequences : second part

Sometimes teeth can move even if they seem to have been perfectly stabilised by a retention wire. We call this phenomenon the “wire syndrome”. It has been well described both in the mandibular and maxillary arches in part one of this article. For the moment, there has been no mechanical explanation for this phenomenon in the scientific literature. After an analysis of photographic documents from fellow specialists and an examination of cases from our own office, we have developed a theory to explain the mechanical element involved. We will divide our analysis into two hypotheses. They could be inter-connected. The first so-called “intrinsic” hypothesis groups together procedural erreurs which all lead to the use of an active bonded wire. In such cases, the wire is directly responsible for the movements. Its action is the same as that of an orthodontic device directly bonded on the teeth. The second “extrinsic” hypothesis shows that a tooth with a well bonded wire can rotate if the link between the wire and the composite is broken and if force is present. The clinical evidence we have gathered could allow us to combat this phenomenon efficiently.

Employment contracts: the inherent dangers of the fixed-term contract

Hiring an employee can be risky, especially when choosing the contract that will bind the employer to the employee. It is essential to choose a suitable contract. Oftentimes, the preferred choice is a fixed-term contract. If the reason for this choice is contested, the financial consequences may be exorbitant.

Fluidity in an orthodontic practice. Why, for who, how?

The search for fluidity in an orthodontic practice must be an imperative axis of reflection. Fluidity is a quality that must be targeted because it is synonymous with efficiency and comfort and, consequently, profitability. This profitability is not exclusively financial. It is also at the level of the human. It allows each member of the team to bring the best of himself in his function. And when a team is successful, patients feel it. A satisfied patient is the best advertisement a practice can have. Why deprive yourself?

Treatment of tongue dysfunction: rehabilitation for prescribers’ practice

Immature tongue function so-called “tongue-thrust or infantile and teeth apart swallow” and its rehabilitation involves multiple specialities in dentistry (pediatric dentistry, orthodontics, management of temporomandibular disorders, periodontics,…). Fifty years ago Mrs Fournier described a tongue rehabilitation technique. Given the difficulty to find a physiotherapist able to practice such a therapeutic, the aim of this article is to describe this therapeutic so that non-physiotherapists practitioners be able to initiate it and to teach it to their patients, at least for simple cases. It includes corrections of tongue immaturity, tongue resting position, deglutition and phonation. These changes might involve adaptive cortical neuroplasticity. Indeed these last years it has been shown in humans that standardised and calibrated tongue lift or protrusion exercises induce such plasticity in the tongue motor cortex.

Functionally orientated/systemic approach to orthodontic treatment of severe class II division 1 malocclusions: an adapted device, the FABP

The orthodontic treatment of severe class II division 1 malocclusions is often difficult, which leads some specialists to offer a surgical correction of the overjet. Treatment is made complex by the value of the horizontal overlap as much as the « depth » of deep bite that is very often present alongside the malocclusion. This is why we are offering a treatment protocol including a FABP (Fixed Anterior Bite Plate) which will allow, if the patient cooperates, to correct the anatomic anomaly while concurrently establishing new masticatory cycles in order to stabilize and preserve the results obtained. It is this systemic approach of treatment that is the focus of this article.