Comment prévenir l’apparition de défauts osseux et/ou gingivaux au cours du traitement orthodontique grâce aux nouveaux outils numériques.

This thesis will analyse the benefits of new digital tools for preventing periodontal recession during orthodontic treatment. Although clinical examinations, clinical photographs and two-dimensional radiographs are essential prior to orthodontic treatment, few data are missing : thickness of bone tissue, presence of dehiscence, etc. This can jeopardize the bony and gingival environment of teeth at the end of orthodontic treatment. That's why we need to look for new methods to reduce the risk of bone and/or gum defects, especially as orthodontic treatment becomes more and more frequent. Thanks to advances in three-dimensional dental imaging (CBCT) and digital dental scan (which include digital orthodontic set-ups), an improvement in patient care seems possible. CBCTs have become increasingly accurate and reliable, digital dental scan can be used to produce digital set-ups, and software exists to superimpose CBCT and digital dental scan of dental crowns. By integrating the digital orthodontic set-up, this could provide us with information on the expected changes in periodontal tissues during orthodontic movements. The objectives of this thesis will therefore be to first establish the current state of knowledge on protocols for integrating periodontal assessment into the orthodontic treatment plan produced by digital set-up. This will be achieved through a narrative review of the literature. Next, we want to think about and propose a workflow for predicting periodontal tissue changes induced by orthodontic movements. The aim is to improve periodontal tissue management in orthodontic treatment.