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Biomedical subjects

H Reychler

Publications and source records attributed to H Reychler.

At least 19 recordsLinked to original sources

3D CT-based cephalometric analysis: 3D cephalometric theoretical concept and software.

INTRODUCTION: We present an original three-dimensional cephalometric analysis based on a transformation of a classical two dimensional topological cephalometry. METHODS: To validate the three-dimensional cephalometric CT based concept we systematically compared the alignments of anatomic structures. We used digital lateral radiography to perform the classical two-dimensional cephalometry, and a three-dimensional CT surface model for the three-dimensional cephalometry. RESULTS: Diagnoses based on both two-dimensional and three-dimensional analyses were adequate, but the three-dimensional analysis gave more information such as the possibility of comparing the right and left side of the skull. Also the anatomic structures were not superimposed which improved the visibility of the reference landmarks. CONCLUSION: We demonstrated that three-dimensional analysis gives the same results as two-dimensional analysis using the same skull. We also present possible applications of the method.

Cephalometry↗

Effects of irradiation on bone remodelling around mandibular implants: an experimental study in dogs.

This research focuses on the effects of radiotherapy on bone remodelling around mandibular implants in dogs. After bilateral extraction of the mandibular premolars and first 2 molars, each of 11 beagles received 8 mandibular implants. Four animals were irradiated 4 weeks after implantation and 4 others 8 weeks before implantation; the remaining 3 did not receive radiotherapy. Irradiation consisted of 10 daily fractions of 4.3Gy (60)Co. Fluorochromes were given at implantation and irradiation to allow the measurement of bone apposition. The dogs were killed 6 months after implantation. Each hemi-mandible was processed according to bone-specific histological techniques. New bone formation was visible around 85 of the 88 implants. Stimulated mandibular remodelling was attested in both irradiated groups by increased porosity and numerous labelled osteons. Resorption was more pronounced in the group irradiated after implantation, but osteon formation appeared unvarying. Osseointegration was thus shown to be compatible with bone irradiation as bone turnover activities were maintained throughout the experiment. As the apposition stage of the remodelling cycle appears crucial to achieve optimal osseointegration, its normal completion should be taken into account in clinical practice by respecting a 6-month period between irradiation and implantation.

Animals↗

[Treatment of drooling: review of the literature].

An exhaustive review of the literature shows the very relative efficiency of diverse treatments for chronic drooling. Morbidity is too high with medical treatments and behavioral treatments require active collaboration from the patient. The different surgical techniques, either based on derivation or ligature of the principal salivary ducts combined with glandular tissue extirpation, are not free of complications. There is much controversy over their efficiency due to the lack of sound evidence. Caution is therefore primordial before proposing surgery for chronic drooling: the available surgical procedures all have technical limitations and clinical trials have demonstrated many failures. At the most, the patient can expect a 50 to a maximum 80% reduction of drooling.

Cholinergic Antagonists↗

Automatic evaluation of the exteroceptive suppression of the temporalis muscle activity.

AIM: To set up a reliable automated method of allowing to identify the ES1 and ES2 periods of exteroceptive suppression of the temporal muscle (EST), thereby reducing their intra- and inter-individual variability. MATERIALS AND METHODS: Analyses were performed in 79 healthy subjects with strict inclusion and exclusion criteria. Each individual underwent two separate examinations 1 week apart. Activity of the left and right temporal muscles was recorded in response to unilateral stimulation of the left and right labial commissures. Wave forms were successively rectified, averaged, and filtered; the intersections of the resulting curve with values corresponding to 50%, 60%, 70%, 75%, and 80% of the control period (20 ms preanalysis time) were automatically determined. RESULTS: All subjects reached a 80% level of attenuation for ES2. The values of ES2 durations were normally distributed. The mean ES1 and ES2 durations didn't vary between the two recording session, and there was a good individual reproducibility from one session to the other. Though relatively high, the inter-individual variability was slightly lower in the second than in the first session. CONCLUSIONS: Computed analysis of EST may contribute to decrease inter- and intra-individual test variability. Letting patient habituate through a first recording session could increase test sensitivity, too. The obtained values for ES2 duration are normally distributed and well-reproducible at both the population and individual level. We suggest taking into account both ES2 duration and level of attenuation.

Adult↗

[Limitations of orthognathic model surgery: theoretical and practical implications].

Orthognathic model surgery is a classical technique used to simulate orthognathic surgical cases. However, a detailed analysis of this technique demonstrates that theoretical errors and inaccuracies can occur in routine practice. 2D and 3D cephalometric analysis is the first source of inaccuracies. Then, during the occlusal plane transfer from the patient to the semi-adjustable dental articulator, errors can occur by inaccurate manipulation of the facial bow. Simulating the operation on the plaster cast is difficult due to the lack of a real link between the cephalometric analysis and the model surgery. Rotation and translation movements of the plaster casts are insufficiently controlled during the model surgery stage. Finally, the splint, which transfers the final relative position of maxilla to the mandible, summates all of the errors of the previous stages.

Cephalometry↗

[Reconstruction of the mobile tongue malignant tumor excision: quality-of-life assessment in 19 patients].

INTRODUCTION: Tumor tongue excision leads to anatomical and functional defects (chewing, swallowing, oral and prosthetic hygiene). The extension of the resection depends on tumor size and surgical radicality. MATERIAL AND METHOD: In our department, 72 cases of lingual tumor were treated between may 1987 and January 1997. 73% of these cases were infiltrating squamous cell carcinomas. 71% were male. Most of the tumors were located at the ventral (45%) and lateral side (36%). 25% of the tumors crossed the midline. Staging was most often pT(2) (46%) and pN(0) (62%). Reconstruction with radial free flap occurred in 37%, with pedicled pectoralis major muscle flap in 13% and with pedicled latissimus dorsi muscle flap in 25% of cases. 51% of the patients were irradiated. All the patients were asked about their quality of live by an 11 questions questionnaire. The questions concerned the different oral and lingual functions and the social, familial, affective and professional life. RESULTS: 19 patients (that means 26%) answered the questionnaire. 9 of them were reconstructed with a flap (6 free radial flaps, 2 pedicled pectoralis major flaps, 1 pedicled latissimus dorsi flap) and were irradiated. In the 10 other patients wounds were closed by simple sutures of the margins. 1 of these 10 patients was irradiated. There was no correlation between scores of the questions and neither pT nor age of patients. We observed a parallelism between scores of the questions about speech and swallowing. Scores of the questions about swallowing were higher when a flap was used for reconstruction, whatever was the type of flap. DISCUSSION: A questionnaire was drawn up from the UW QOL questionnaire. It was a simplified questionnaire with reduced number of questions and simple words. Lesser tongue immobility leads to a better swallowing. Swallowing and speech were worst when tongue resection was large. In this quality of life study, there was a few number of patients that answered the questionnaire so that it is impossible to make a difference between the different flaps.

Adenocarcinoma↗

[Complications after third molar extractions: retrospective analysis of 1,213 teeth].

BACKGROUND: This retrospective study was conducted to analyze per and postoperative complications associated with third molar extraction. Our objective was to determine the appropriate moment for extraction. MATERIAL AND METHODS: The study included 367 patients, selected randomly among the population treated between January 1992 and December 1996. A total of 1213 third molars were extracted: 603 under local anesthesia in 83 men and 136 women, mean age 24.9 years (range 11-70); 610 under general anesthesia in 44 men and 104 women, mean age 19.9 years (range 12-62 years). The patients were divided into three groups by age: 11-18 years, 19-30 years, and 31 years and over. Extractions were performed by senior (n=4) and junior (n=7) surgeons who used the same standard operative technique for all patients. RESULTS: The overall complication rate for extractions conducted under local anesthesia was 12.6% for lower third molars and 2% for upper third molars. The most frequent complication was secondary infection (3.6%) for the mandible and fracture of the tuberosity and bucco-sinus communication for the maxillary. The overall complication rate for extractions conducted under general anesthesia was 8.2% for lower third molars and 1.5% for upper third molars. Complications were more frequent, for the entire cohort, when the operator was less experienced, the subject was older, and the tooth was deeply embedded. DISCUSSION: These results are in agreement with data in the literature. Based on our experience, we propose extraction of third molars during adolescence when the x-ray indicates normal eruption cannot be expected due to lack of space or an abnormal position.

Adolescent↗

[Auto-transplantation of an impacted or retained maxillary canine. Apropos of a case].

Transplantation of an impacted or retained maxillary canine is a common procedure. Bone width at the transplantation site may however be insufficient to accept the transplanted tooth diameter. We describe an original transplantation technique of a high and buccal impacted canine with bone support and gingival transposition. The transplanted tooth remained stable over time and the alveolar profile was normal. Ankylosis and periodontal pocket are observed after healing. Ankylosis was also present before the procedure. The periodontopathy was explained by the lack of periodontal ligament on the distal aspect of the lateral incisor root in front of the canine crown before transplantation. Pocket depth was reduced after periodontal therapy. This technique allows anatomic restoration and an acceptable periodontal environment.

Adult↗

[Indications for orthognathic surgery, the limitations of orthodontics and of surgery].

The different sagittal, vertical or transversal skeletal dysmorphosis can be treated with orthodontic or orthopaedic appliances. Certain limits of treatment will be due to the age of the patient, the importance of the skeletal dysmorphosis, technical limits of the orthodontic appliances or the motivation and compliance needed from the patient. For this reason an orthodontic treatment combined with orthognathic surgery may be indicated. Nevertheless the combined orthodontic-surgical treatment has also its limitations and specific treatment needs from orthodontist and maxillo-facial surgeon.

Adolescent↗

[Complications and failures in orthognathic surgery].

This paper reviews the literature about the most relevant complications in daily orthognathic surgery. Although orthognathic surgery has proven to be relatively safe, patients who undergo such maxillofacial orthopaedic surgery must be aware of the side effects of this combined treatment. Immediate life-threatening complications are very rare. They can in most cases be avoided by good anaesthetic and surgical techniques and adequate postoperative care. The most frequently encountered perioperative problem in maxillary surgery is excessive blood loss, whilst subjective neurosensory disturbance is the most frequent complication in mandibular surgery. Good co-operation between orthodontist and surgeon is essential to prevent most immediate and late postoperative problems and nearly all unsatisfactory results.

Blood Loss, Surgical↗

[Selection and delineation of lymph node target volumes in head and neck neoplasms].

This article reviews all clinical and pathological data available in the literature supporting the concept of selectivity in the neck nodes to be included in the Clinical Target Volume for head and neck squamous cell carcinoma. Using the terminology of neck node levels and the guidelines for the surgical delineation of these levels proposed by the Committee for Head and Neck Surgery and Oncology of the American Academy for Otolaryngology-Head and Neck Surgery, recommendations are proposed for both the selection and the delineation of lymph node target volumes.

Carcinoma, Squamous Cell↗

[Orthognathic surgery, master-piece of maxillo-facial surgery].

Orthognathic surgery is this field of the maxillofacial surgery which aims to reposition the jaws or some segments of these jaws when masticatory dysfunctions are evident. This tridimensional repositioning in the craniofacial skeleton allows to restore the masticatory function by means of osteotomies, which must be followed either by preoperative simulated bony displacements or by callus bone distraction. Not only are the functional benefits evident on the dental, articular and neuromuscular levels, but also a facial esthetic harmony can almost be obtained.

Humans↗

Sialolithiasis in children as a diagnostic dilemma.

Sialolithiasis is an uncommon disorder in childhood. Initially asymptomatic, symptoms may appear gradually. These can vary from moderate discomfort to severe pain with large glandular swelling accompanied by trismus. The correct interpretation of symptoms and a proper investigation for localization of salivary stones are important for effective treatment. A case of submandibular sialolithiasis in a 9-year-old girl is used to exemplify the problems had in clinical diagnosis.

Child↗

Selection and delineation of lymph node target volumes in head and neck conformal radiotherapy. Proposal for standardizing terminology and procedure based on the surgical experience.

The increasing use of 3D treatment planning in head and neck radiation oncology has created an urgent need for new guidelines for the selection and the delineation of the neck node areas to be included in the clinical target volume. Surgical literature has provided us with valuable information on the extent of pathological nodal involvement in the neck as a function of the primary tumor site. In addition, few clinical series have also reported information on radiological nodal involvement in those areas not commonly included in radical neck dissection. Taking all these data together, guidelines for the selection of the node levels to be irradiated for the major head and neck sites could be proposed. To fill the missing link between these guidelines and the 3D treatment planning, recommendations for the delineation of these node levels (levels I-VI and retropharyngeal) on CT (or MRI) slices have been proposed using the guidelines outlined by the Committee for Head and Neck Surgery and Oncology of the American Academy for Otolarynology-Head and Neck Surgery. These guidelines were adapted to take into account specific radiological landmarks more easily identified on CT or MRI slices than in the operating field.

Carcinoma, Squamous Cell↗

[Nosologic descriptions of lesions of the oral mucosa].

This article describes extensively and systematically oral mucosa diseases. Macroscopical aspects are particularly described in order to give the dentist all important elements of differential diagnosis. This nosological description is based on a clinical approach: white and pigmented lesions are distinguished from ulcerated and benign so as malignant tumoral lesions. Specifically on the oral mucosa located lesions and oral mucosa lesions of systemic diseases are described.

Cysts↗