Orthognathic surgery has as its objective the repositioning of basal bone in the framework of maxillo-mandibular deformities. Its results are both esthetic and functional. For adults, improved aesthetics results is becoming increasingly important in these procedures to the point where some patients seek only an esthetic amelioration and not a functional one. To achieve their aesthetic purpose, it is becoming progressively more necessary for orthodontists, oral surgeons, and general dentists to collaborate effectively in a well-coordinated effort. In what has now become a true sub-specialty, orthognathic surgeons must master the complementary techniques of rhinoplasty, osseous apposition, aesthetic facial surgery, fat injection or injectable anti-aging tratments. In this article we propose a diagnostic classification based on the aesthetics of the adult smile and describe the therapeutic modalities appropriate for each element.

Many defects can affect the smile of our patients. For superficial enamel defects that may involve one or several natural teeth, we have perfected, after trying many different methods of treatment, a simple, rapid, atraumatic and very effective technique.

This method has five successive stages: a chemical whitening at the chair, an enameloplasty, a microabrasion, a careful polishing, and a remineralization treatment.

This method is especially used for patients who present superficial enamel defects (chalky white veils, leucomas, brown spots, pitting,…).

For deeper defects, it is sometimes necessary to complete this treatment with composite or ceramic restorations.

This article presents solutions to problems posed by missing teeth in the anterior sector of the arch by synthesizing three groups of parameters, those related to patients, those related to dentists, and those related to the orthodontist.

But the patient, or the parents of patients who are young children, in consultation with the treatment professionals, must make the final decision.

In France, the Public Health Code was amended in 2004, and now allows dentists to treat facial tissues adjacent to the mouth: and hence, they can now bridge the gap between maxillary sinuses and the mouth area by performing hyaluronic acid injection procedures in the perio-buccal soft tissues.

Accordingly, the National Council of the Order of Dental Surgeons authorizes the practice of hyaluronic acid injection for therapeutic use.

In this article, we will define the legal framework for which we will be held liable as it pertains to hyaluronic acid injection procedures.

After explaining the physico-chemical properties of hyaluronic acid, we will study the mechanisms of ageing, the architecture of the face and various methods of injection.

We will look at the indications and counter indications for the use of hyaluronic acid injection, particularly in terms of its therapeutic usefulness for rehabilitating soft tissue when transitioning from a maxillary full-arch prosthesis to an implant born bridge.

Hyaluronic acid makes it possible to offset the lack of buccal margin of the resin-based removable prosthesis.

If thickening of gingival soft tissue and root coverage are indicated, these two procedures should be performed prior to starting orthodontic treatment. The decision to initiate these treatments can be made only based on a clinically exact and reproducible diagnosis. The case described in this article is that of a 53-year-old woman presenting Miller Class III gingival recessions from 13 to 23 and 32 to 42. Because of this impairment, she needs orthodontic treatment. The patient’s periodontal biotype is thin.

The objective of the surgery discussed in this article is both to thicken the periodontium of the patient and to promote coverage of the recessions. To achieve these two objectives, we have chosen the modified “envelope” technique with insertion of connective tissue.

The 18 month post-operative results show an excellent rate of root coverage and a significant esthetic improvement of the gingiva.

In general, the smile that orthodontists try to create at the end of treatment satisfies objective functional criteria as well as subjective esthetic criteria.

It’s obvious that in today’s society, a smile plays an important role in nonverbal communication: restoring or enhancing this smile is, in fact, the main reason patients consult their orthodontists.

After reviewing the literature, we were able to identify various factors involved in the perception of a smile and to underscore the esthetic connection between the smile and the face.

Is there a relationship between the smile and facial harmony?

What are the objective criteria that allow us to discern whether a smile is pleasant or not?

Our study confirmed that the esthetics of the face correlates with the perception of the smile and that the factors discussed in the literature pertaining to this correlation are valid.

However, the study has also made it possible to clarify the respective influence of various factors as they relate to a pleasant smile, an unattractive smile or an unsightly smile. Therefore, our study has shown that objective functional criteria are involved in the entirely subjective esthetic realm of a smile.

The relationship between English and French is complicated by the abundance of false cognates found in each language. The word evidence, first appears in the XIVth century, in both French and English literature and means: that which becomes visually apparent (from the Greek εἴδω, or from Latin ex-videre “to see”); that which is perceived; that which is grasped by the mind; that which is obvious, indisputable, clear, patent.