Les fêlures dentaires

LYON1-BU Santé Odontologie (693882213) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

À propos d’un cas de résorptions radiculaires sévères en orthodontie : quelle étiologie et quelle prise en charge?

Introduction: Root resorptions are, with white spots, some of the inconveniences caused by orthodontic treatments. Although they are rare, they should not be ignored despite the many benefits gained by orthodontic treatment. Contrary to white spots, which are controllable by good dental hygiene, root resorptions can occur despite patient cooperation. Orthodontists should be aware of this phenomenon and make regular radiologic controls a priority for detection “before, during and after” treatment. Material and Method: After literary references, the presentation of the case report will illustrate the role of the orthodontist in the preservation and care of teeth damaged by impacted cuspids. Discussion: The discussion will focus on the prevention and the interception of those phenomena, the etiologic research on these cases, on medical supervision and prognostic for damaged teeth. Conclusion: Before the conclusion, we will evoke the contribution of the cone-beam in the diagnosis of root resorption

L’imagerie numérique : outil de la gestion thérapeutique des dents incluses

Le traitement avec dégagement chirurgical et mise en place orthodontique de canines incluses étant complexe, la décision thérapeutique finale doit s’appuyer sur une concertation pluridisciplinaire impliquant l’orthodontiste et le praticien responsable de l’acte chirurgical. Pour améliorer le pronostic et réduire les échecs et ré-interventions, une appréciation initiale précise de la localisation de la dent, de la présence de résorption initiale, de la direction de traction et de l’ancrage nécessaire, est indispensable. Lorsque l’imagerie conventionnelle ne fournit pas toutes les informations souhaitées, une analyse tridimensionnelle peut être recommandée afin de mieux localiser une dent incluse et mieux visualiser les structures associées. La sensibilité diagnostique de la radiologie conventionnelle étant peu élevée pour la détection de résorptions des dents adjacentes, le scanner augmente celle-ci de 50% en moyenne. Le cone beam peut être proposéafin d’améliorer la prise en charge du patient en se substituant au scanner plus irradiant. L’imagerie médicale en reconstruction 3D est non seulement une aide pour l’orthodontiste de façon à visualiser et mettre en place la mécanique la plus adaptée compte tenu du contexte mais sert aussi au praticien qui va réaliser l’acte de façon à optimiser sa procédure de dégagement (respect des structures environnantes) pour le bien du patient

HIFUture 2021: Programme de la 1ère édition. 17-18 Juin 2021, Lyon, France

HIFUture is a French Scientific Symposium whose 1st edition has been launched in 2021 to bring together clinicians, researchers, engineers and industrialists involved in the development of ultrasound treatments in France and abroad, with an eye to imagine today the ultrasound treatments of tomorrow. The first edition of the conference was organized in Lyon (France) on June 17-18, 2021 by the Laboratory of Therapeutic Applications of Ultrasound (LabTAU, INSERM, Univ Lyon) and the Hospices Civils de Lyon (HCL)

Evaluation of an e-learning program for the diagnosis of rectosigmoid endometriosis with rectal water contrast transvaginal ultrasonography (rectosonography)

International audienceThis study aimed to evaluate the value of an e-learning program for the diagnosis of rectosigmoid endometriosis lesions using rectal water contrast transvaginal ultrasonography (rectosonography/RSG). Theoretical RSG training using videos with a commentary was offered online to healthcare professionals involved in ultrasound screening for endometriosis. A test (without correction) with 24 RSG video loops was used to assess the participants' baseline level before the training and their improvement afterwards. If the success rate post-training was below 80%, the participant could start over with another series of 24 videos. Between February and June 2020, thirty participants took the training course (of which 80% were obstetrics-gynaecology residents). The e-learning program resulted in a significant performance increase in the diagnosis of rectosigmoid endometriosis lesions, with a higher test success rate after the training compared to before (74.4% and 63.6% respectively; +10.8%; 95% CI [6,6; 15]; p< 0.001). Significant improvement was also observed regarding the overall skills involved in the ultrasound diagnosis of deep infiltrating endometriosis (+9.2%; p< 0.001), the accurate diagnosis of the height of bowel lesions (+14.7%; p< 0.001) and uterosacral ligament lesions (+8%; p< 0.005). In conclusion, our e-learning program led to a significant improvement of the diagnostic performance of digestive endometriosis using transvaginal ultrasound with intrarectal water contrast (rectosonography). Adding feedback to the post-test video loops could further increase the efficacy of the e-learning training

Comparison of three-dimensional rectosonography, rectal endoscopic sonography and magnetic resonance imaging performances in the diagnosis of rectosigmoid endometriosis

International audienceStudy objective: Comparison of 3D-rectosonography (3D-RSG), rectal endoscopic sonography (RES), and MRI performances in the diagnosis of rectosigmoid endometriosis using surgery as the Gold Standard.Design: Monocentric retrospective longitudinal study on diagnostic procedures.Design clasification: Canadian Task Force II-2.Setting: University Hospital of Lyon Croix-Rousse.Patients: A total of 37 patients treated surgically for pelvic endometriosis.Interventions: Expert 3D-RSG (3D Transvaginal sonography with water contrast in the rectum), MRI and RES performed by expert examiners. Sensitivity, specificity, accuracy, positive and negative predictive value, positive and negative likelihood ratios were calculated. Depth, size, and volume of intestinal lesions were also compared to the type of surgery performed (shaving versus segmental resection).Measurements and main results: Rectosigmoid endometriosis lesion was confirmed by surgery in 31 patients on 37 (84%). Sensitivity, specificity, accuracy, positive and negative predictive value, positive and negative likelihood ratios for 3D-RSG were 94%, 100%, 95%, 100%, 75%, +∞ and 0.06 respectively; for RES 81%, 100%, 84%, 100%, 50%, +∞ and 0.19 respectively; while for MRI 90%, 100%, 92%, 100%, 67%, +∞ and 010 respectively. There was no significant difference between the 3 procedures (p > 0.05).Conclusion: 3D-RSG, RES and MRI seem to be 3 effective procedures in the diagnosis of rectosigmoid endometriosis. Their performances seem equivalent

Surgical management of endometriotic women with pregnancy intention in France: A national snapshot of centers performing a high volume of endometriosis procedures.

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Surgical Management of Urinary Tract Endometriosis: A one-year Longitudinal Multicenter Pilot Study at 31 French Hospitals (by the FRIENDS Group)

International audienceStudy ObjectiveTo describe the surgical management and risks of postoperative complications of patients with urinary tract endometriosis in France in 2017.DesignMulticenter retrospective cohort pilot study.SettingDepartments of gynecology at 31 expert endometriosis centers.PatientsAll women managed surgically for urinary tract endometriosis from January 1, 2017, to December 31, 2017. We distinguished patients with isolated bladder endometriosis or isolated ureteral endometriosis (IUE) from those with endometriosis in both locations (mixed locations [ML]).InterventionsSurgeons belonging to the French Colorectal Infiltrating Endometriosis Study (FRIENDS) group enrolled patients who filled a 24-item questionnaire on the day of the inclusion and 3 months later. Data were collected on operative routes, surgical management, and postoperative complications according to the Clavien-Dindo classification in a single anonymized database.Measurements and Main ResultsA total of 232 patients from 31 centers were included. Isolated bladder endometriosis was found in 82 patients (35.3%), IUE in 126 patients (54.4%), and ML in 24 patients (10.3%). Surgery was performed by laparoscopy, laparotomy, or robot-assisted laparoscopy in 74.1%, 11.2%, and 14.7% of the cases, respectively. Among the 150 ureteral lesions (IUE and ML), 114 were managed with ureterolysis (76%), 28 with ureteral resection (18.7%), 4 with nephrectomy (2.7%), and 23 with cystectomy (15.3%). Concerning bladder endometriosis, a partial cystectomy was performed in 94.3% of the cases. We reported 61 postoperative complications (26.3%): 44 low-grade complications according to the Clavien-Dindo classification (18%), 16 grade III complications (7%), and 1 grade IV complication (peritonitis).ConclusionThe surgical management of ureteral and bladder endometriosis is usually feasible and safe through laparoscopic surgery. Ureteral resection, when necessary, is more strongly associated with laparotomy and with more complications than other procedures. Prospective controlled studies are still mandatory to assess the best surgical management for patients