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Pathologies osseuses des maxillaires récidivantes

100%

Olszewski R., Reychler H.

Nemesis. Negative Effects in Medical Sciences Oral and Maxillofacial Surgery

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2018

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vol. 1

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issue 1

1-47

EN

Maxillofacial bone diseases represent a heterogeneous group involving benign and malign tumors, and metabolic, malformative, and infectious diseases. They have a tendency to relapse even with a good initial treatment. Therefore, we need to start with active surveillance based on medical imaging (CT scanner). The treatment of maxillofacial bone diseases is based mainly on clinical examination, radiological findings, and pathological diagnosis. The treatment consists of curettage or maxillary/mandibulary interruptive or not-interruptive bone resection. Development of guidelines seems impossible due to the heterogenicity of clinical presentations. The individualized treatment should prevail.

FR

Plusieurs pathologies osseuses des maxillaires ont comme caractéristique une tendance à la récidive, et ce même après un traitement approprié. Il convient donc de les reconnaître afin de pouvoir les surveiller, à la fois cliniquement et par une technique d’imagerie appropriée. On distinguera ici des pathologies tumorales bénignes et malignes, métaboliques, malformatives et infectieuses. Actuellement, le CT scan est la technique d’imagerie médicale de premier choix pour établir le diagnostic différentiel et permettre la surveillance de ces pathologies osseuses. Le traitement de ces pathologies récidivantes est soit le curetage/énucléation si possible (corticales non rompues) soit une résection interruptrice ou non des maxillaires ou de la mandibule, et ce en fonction des données cliniques et surtout anatomopathologiques à discuter et envisager au cas par cas, la généralisation dans ce domaine étant impossible voire dangereuse pour le patient. Il ne peut donc être question de proposer des recommandations ni des algorithmes décisionnels.

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Paget’s disease of bone, biphosphonates and jaw osteonecrosis: a case report

81%

Magremanne M., Grysolle A., Reychler H.

Nemesis. Negative Effects in Medical Sciences Oral and Maxillofacial Surgery

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2019

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vol. 4

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issue 1

15-15

EN

Objective: Paget’s disease of bone is characterized by a focal increase in bone resorption and accelerated bone formation leading to a weaker and disorganised bone. Bisphosphonates (BPs) have been the treatment of choice of Paget’s disease since the 1990s. Medication related osteonecrosis of the jaw (MRONJ) is a rare event in non oncologic patients. We describe a rare case of Paget’s disease involving the maxilla with osteonecrosis in a context of bisphosphonate treatment. Case report: an 87-year-old woman presented with 4 episodes of bone necrosis in 15 years. In this case report there is a clear chronologic association between the occurrence of MRONJ and the administration of iv BP for Paget’s disease. Maxillofacial involvement of Paget’s disease occurs in less than 15% of cases. There is a lack of information in the literature about the association of MRONJ and Paget’s disease. Even if osteonecrosis of the jaw could be a consequence of the disease, in this case, it is more in relation to the BP treatment. Conclusions: Although MRONJ might be considered a rare condition in Paget’s disease, patients prior to starting antiresorptive therapy and in particular iv BPs should have a complete dental examination and panoramic X-Ray. Nemesis relevance: side effect of bisphosphonate treatment

3

Three-dimensional analysis of airway space and mandibular morphology in Pierre Robin sequence using cone beam computed tomography.

61%

Olszewski R., Dontaine T., Odri G. A., Zech F., Bayet B., Reychler H.

Nemesis. Negative Effects in Medical Sciences Oral and Maxillofacial Surgery

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2018

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vol. 2

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issue 1

1-27

EN

Objectives: The Pierre Robin sequence (PRS) is defined by retromicrognathia, glossoptosis, and sleep apnea and can also be associated with cleft palate. Diagnosis, management and mandibular catch-up growth are still controversial issues in PRS patients. The aim of our retrospective study was to evaluate in three dimensions (3D) the airway space and mandibular morphology in PRS compared to a normal control group patients in the pre-orthodontic period of life. The null hypothesis was that we would not find a significant difference between the PRS and control group patients in oropharyngeal airway volume measurements. Material and methods: We analyzed 9 PRS patients (mean age: 8 years-old) who underwent cleft palate surgery in the first four months of life, performed by the same surgeon using the same technique. Cone-beam computed tomography (CBCT) was performed in these patients after local ethical committee approval. The control group consisted of 15 patients (mean age: 9 years-old) with CBCT already performed for other reasons. 3D Slicer was used in both groups for semi-automatic segmentation of the airway space. Two independent observers performed semi-automatic segmentations twice in each patient with a one- week interval between the two series of measurements. Airway volume was automatically measured using 3D Slicer. We also developed a 3D cephalometric analysis with Maxilim software in order to define a 3D mandibular morphology which consisted of 25 landmarks, 4 planes, and 23 distances. Two independent observers performed the 3D cephalometric analysis twice for each patient, with a one- week interval between the two series of measurements. Results: There was no significant difference in the intra- and inter-observer measurements between the PRS and control groups for airway space volume (p<0.05). However, there was a significant difference in the shape of the mandible between the PRS group and the control group (p<0.05). Conclusions: Vertical ramus width and mandibular global anteroposterior length were significantly lower in the PRS group. Mandibular hypoplasia could be found in PRS patients not only in the horizontal dimension. Nemesis relevance: the null hypothesis was confirmed. Moreover we failed to find exactly the same control group under 9 years-old due to radioprotection restrictions of application of cone beam CT in children.

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3 Nemesis. Negative Effects in Medical Sciences Oral and Maxillofacial Surgery

1 2019

2 2018

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1 Dontaine T.

1 Grysolle A.

1 Magremanne M.

1 Odri G. A.

1 Zech F.

Pathologies osseuses des maxillaires récidivantes

Paget’s disease of bone, biphosphonates and jaw osteonecrosis: a case report

Three-dimensional analysis of airway space and mandibular morphology in Pierre Robin sequence using cone beam computed tomography.