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1.
Arch Pediatr ; 30(6): 366-371, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37188563

ABSTRACT

BACKGROUND: Infantile hemangiomas (IHs) can be part of PHACE (posterior fossa anomalies, hemangioma, arterial anomalies, cardiac anomalies, eye anomalies) syndrome when they are segmental, extensive, and located on the face or neck. The initial assessment is codified and well known, but there are no recommendations for the follow-up of these patients. The aim of this study was to assess the long-term prevalence of different associated abnormalities. METHODS: Patients with a history of large segmental IHs of the face or neck. diagnosed between 2011 and 2016 were included in the study. Each patient underwent an ophthalmological, dental, ENT (ear, nose, and throat), dermatological, neuro-pediatric, and radiological assessment at inclusion. Eight patients including five with PHACE syndrome were prospectively evaluated. RESULTS: After a mean follow-up of 8.5 years, three patients presented with an angiomatous aspect of the oral mucosa, two with hearing loss, and two with otoscopic abnormalities. No patients developed ophthalmological abnormalities. The neurological examination was altered in three cases. Brain magnetic resonance imaging follow-up was unchanged in three out four patients and revealed atrophy of the cerebellar vermis in 1 patient. Neurodevelopmental disorders were found in five of the patients and learning difficulties were observed in five patients. The S1 location appears to be associated with a higher risk of neurodevelopmental disorders and cerebellar malformations, while the S3 location was associated with more progressive complications, including neurovascular, cardiovascular, and ENT abnormalities. CONCLUSION: Our study reported late complications in patients with a large segmental IH of the face or neck, whether associated with PHACE syndrome or not, and we proposed an algorithm to optimize the long-term follow-up.


Subject(s)
Aortic Coarctation , Eye Abnormalities , Hemangioma , Neurocutaneous Syndromes , Humans , Child , Infant , Prospective Studies , Follow-Up Studies , Eye Abnormalities/diagnosis , Eye Abnormalities/complications , Eye Abnormalities/pathology , Aortic Coarctation/complications , Aortic Coarctation/diagnosis , Aortic Coarctation/pathology , Neurocutaneous Syndromes/diagnosis , Neurocutaneous Syndromes/complications , Neurocutaneous Syndromes/pathology , Hemangioma/diagnosis , Hemangioma/pathology , Syndrome
2.
Mol Biol Rep ; 48(4): 3799-3812, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33761086

ABSTRACT

Since the discovery of dental pulp stem cells, a lot of teams have expressed an interest in dental pulp regeneration. Many approaches, experimental models and biological explorations have been developed, each including the use of stem cells and scaffolds with the final goal being clinical application in humans. In this review, the authors' objective was to compare the experimental models and strategies used for the development of biomaterials for tissue engineering of dental pulp with stem cells. Electronic queries were conducted on PubMed using the following terms: pulp regeneration, scaffold, stem cells, tissue engineering and biomaterial. The extracted data included the following information: the strategy envisaged, the type of stem cells, the experimental models, the exploration or analysis methods, the cytotoxicity or viability or proliferation cellular tests, the tests of scaffold antibacterial properties and take into account the vascularization of the regenerated dental pulp. From the 71 selected articles, 59% focused on the "cell-transplantation" strategy, 82% used in vitro experimentation, 58% in vivo animal models and only one described an in vivo in situ human clinical study. 87% used dental pulp stem cells. A majority of the studies reported histology (75%) and immunohistochemistry explorations (66%). 73% mentioned the use of cytotoxicity, proliferation or viability tests. 48% took vascularization into account but only 6% studied the antibacterial properties of the scaffolds. This article gives an overview of the methods used to regenerate dental pulp from stem cells and should help researchers create the best development strategies for research in this field.


Subject(s)
Dental Implantation/methods , Dental Pulp/physiology , Regeneration , Stem Cell Transplantation/methods , Tissue Engineering/methods , Animals , Dental Implantation/adverse effects , Dental Pulp/blood supply , Dental Pulp/cytology , Humans , Neovascularization, Physiologic , Stem Cell Transplantation/adverse effects
4.
J Stomatol Oral Maxillofac Surg ; 120(3): 188-195, 2019 Jun.
Article in English | MEDLINE | ID: mdl-30453102

ABSTRACT

INTRODUCTION: Hyperactivity of the lateral pterygoid muscle (LPM) is one of the presumed mechanisms of the onset of temporomandibular disorders (TMD) and explains why intramuscular injection of botulinum toxin (BT) may be indicated for treatment. Intramuscular injection without guidance is difficult because of its deep location. The objectives of this study were to determine the feasibility of MR-guided navigation for BT injection in the LPM in TMD and to report about our first results. PATIENTS AND METHODS: Six patients suffering from persistent myogenic TMD were enrolled in a prospective study and treated with intramuscular injection of BT A: 20 UI in each LPM with MR-guided navigation using the Brainlab plateform (Kolibri®, Brainlab®, Munich, Germany) the target being the center of the upper head, 30 UI in each masseter and 20 UI in each temporal with clinical guidance. The investigated outcomes were: pain intensity, maximum interincisal opening and joint sounds. RESULTS: MR-guided navigation could be used in all patients and the target could constantly be reached. Pain improvement [mean reduction of 4.4 on a numeric scale (p = 0.0579)] was observed in 66.7% of the patients. Significant improvement of maximum interincisal opening was found (p = 0.0360) and joint sounds tend to disappear (p = 0.5594). DISCUSSION: MR-guided navigation is an effective method for tracking the upper head of the LPM and allows for a precise injection of BT. Injection of BT in the upper head of the LPM, the masseter and the temporal muscles is effective in refractory TMD. A combination of this morphologic guidance with electromyographic tracking would allow to select more carefully the muscles to be injected.


Subject(s)
Botulinum Toxins , Temporomandibular Joint Disorders , Germany , Humans , Prospective Studies , Pterygoid Muscles
5.
Int Endod J ; 51 Suppl 4: e252-e263, 2018 May.
Article in English | MEDLINE | ID: mdl-28109162

ABSTRACT

AIMS: To isolate and characterize dental pulp stem cells (DPSCs) obtained from carious and healthy mature teeth extracted when conservative treatment was not possible or for orthodontic reasons; to evaluate the ability of DPSCs to colonize, proliferate and differentiate into functional odontoblast-like cells when cultured onto a polycaprolactone cone made by jet-spraying and prototyped into a design similar to a gutta-percha cone. METHODOLOGY: DPSCs were obtained from nine carious and 12 healthy mature teeth. Then cells were characterized by flow cytometry and submitted to multidifferentiation to confirm their multipotency. These DPSCs were then cultured on a polycaprolactone cone in an odontoblastic differentiation medium. Cell proliferation, colonization of the biomaterial and functional differentiation of cells were histologically assessed. For the characterization, a t-Student test was used to compare the two groups. RESULTS: In all cell cultures, characterization highlighted a mesenchymal stem cell phenotype (CD105+, CD90+, CD73+, CD11b-, CD34-, CD45-, HLA-DR-). No significant differences were found between cultures obtained from carious and healthy mature teeth. DPSCs from both origins were able to differentiate into osteocytes, adipocytes and chondrocytes. Cell colonization was observed both on the surface and in the thickness of polycaprolactone cones as well as a mineralized pericellular matrix deposit composed of type I collagen, alkaline phosphatase, osteocalcin and dentin sialophosphoprotein. CONCLUSIONS: DPSCs were isolated from both carious and healthy mature teeth. They were able to colonize and proliferate within a polycaprolactone cone and could be differentiated into functional odontoblast-like cells.


Subject(s)
Cell Differentiation/physiology , Dental Caries/metabolism , Dental Pulp/cytology , Odontoblasts/cytology , Stem Cells/cytology , Adolescent , Adult , Cell Culture Techniques , Cell Proliferation/physiology , Female , Flow Cytometry , Humans , Male , Phenotype , Polyesters , Tissue Scaffolds , Tooth Extraction
6.
J Stomatol Oral Maxillofac Surg ; 118(4): 206-212, 2017 Sep.
Article in English | MEDLINE | ID: mdl-28732777

ABSTRACT

INTRODUCTION: 3D printing seems to have more and more applications in maxillofacial surgery (MFS), particularly since the release on the market of general use 3D printers several years ago. The aim of our study was to answer 4 questions: 1. Who uses 3D printing in MFS and is it routine or not? 2. What are the main clinical indications for 3D printing in MFS and what are the kinds of objects that are used? 3. Are these objects printed by an official medical device (MD) manufacturer or made directly within the department or the lab? 4. What are the advantages and drawbacks? METHODOLOGY: Two bibliographic researches were conducted on January the 1st, 2017 in PubMed, without time limitation, using "maxillofacial surgery" AND "3D printing" for the first and for the second "maxillofacial surgery" AND "computer-aided design" AND "computer-aided manufacturing" as keywords. Articles in English or French dealing with human clinical use of 3D printing were selected. Publication date, nationality of the authors, number of patients treated, clinical indication(s), type of printed object(s), type of printing (lab/hospital-made or professional/industry) and advantages/drawbacks were recorded. RESULTS: Two hundred and ninety-seven articles from 35 countries met the criteria. The most represented country was the People's Republic of China (16% of the articles). A total of 2889 patients (10 per article on average) benefited from 3D printed objects. The most frequent clinical indications were dental implant surgery and mandibular reconstruction. The most frequently printed objects were surgical guides and anatomic models. Forty-five percent of the prints were professional. The main advantages were improvement in precision and reduction of surgical time. The main disadvantages were the cost of the objects and the manufacturing period when printed by the industry. DISCUSSION: The arrival on the market of low-cost printers has increased the use of 3D printing in MFS. Anatomic models are not considered to be MDs and do not have to follow any regulation. Nowadays, they are easily printed with low-cost printers. They allow for better preoperative planning and training for the procedures and for pre-shaping of plates. Occlusal splints and surgical guides are intended for the smooth transfer of planning to the operating room. They are considered to be MDs and even if they are easy to print, they have to follow the regulations applying to MDs. Patient specific implants (custom-made plates and skeletal reconstruction modules) are much more demanding objects and their manufacturing remains nowadays in the hands of the industry. The main limitation of in-hospital 3D printing is the restrictive regulations applying to MDs. The main limitations of professional 3D printing are the cost and the lead time. 3D printed objects are nowadays easily available in MFS. However, they will never replace a surgeon's skill and should only be considered as useful tools.


Subject(s)
Oral Surgical Procedures/methods , Printing, Three-Dimensional , Computer-Aided Design , Humans , Mandibular Reconstruction/methods , Models, Anatomic , Oral Surgical Procedures/trends , Printing, Three-Dimensional/trends , Surgery, Oral/methods , Surgery, Oral/trends
7.
Article in French | MEDLINE | ID: mdl-26071022

ABSTRACT

Health care facilities more and more use 3D printing, including making their own medical devices (MDs). However, production and marketing of MDs are regulated. The goal of our work was to clarify what is the current French regulation that should be applied concerning the production of custom-made MDs produced by 3D printing in a health care facility. MDs consist of all devices used for diagnosis, prevention, or treatment of diseases in patients. Prototypes and anatomic models are not considered as MDs and no specific laws apply to them. Cutting guides, splints, osteosynthesis plates or prosthesis are MDs. In order to become a MD manufacturer in France, a health care facility has to follow the requirements of the 93/42/CEE directive. In addition, custom-made 3D-printed MDs must follow the annex VIII of the directive. This needs the writing of a declaration of conformity and the respect of the essential requirements (proving that a MD is secure and conform to what is expected), the procedure has to be qualified, a risk analysis and a control of the biocompatibility of the material have to be fulfilled. The documents proving that these rules have been respected have to be available. Becoming a regulatory manufacturer of MD in France is possible for a health care facility but the specifications have to be respected.


Subject(s)
Equipment and Supplies , Medical Device Legislation , Models, Anatomic , Printing, Three-Dimensional/legislation & jurisprudence , Certification , Commerce , Equipment and Supplies/economics , Equipment and Supplies/standards , France , Humans , Medical Device Legislation/trends , Printing, Three-Dimensional/standards
8.
Rev Stomatol Chir Maxillofac ; 113(4): 212-30, 2012 Sep.
Article in French | MEDLINE | ID: mdl-22939162

ABSTRACT

The use of membranes in pre-implantation surgery is part of the guided bone regeneration (GBR) concept, one of the usual bone augmentation techniques. Membranes for GBR procedures have two main uses: a mechanical function to maintain bone regeneration space and a physical function as cellular barrier. The goal is to promote colonization of the regeneration space located under the membrane, by osteogenic cells from the residual bone walls. GBR was the subject of numerous publications and protocols since its first use in the 1980s. These protocols are mainly supported by team experience and the level of evidence is poor. Few indications are truly validated. The goal of our study was to review the recent literature on membrane use for pre-implantations surgery, and, in the absence of any consensus, to provide some arguments for their rational use.


Subject(s)
Bone Regeneration/physiology , Bone Transplantation , Guided Tissue Regeneration/methods , Membranes, Artificial , Oral Surgical Procedures/methods , Bone Transplantation/methods , Dental Implantation, Endosseous/methods , Dental Implants , Guided Tissue Regeneration, Periodontal , Humans , Models, Biological , Oral Surgical Procedures, Preprosthetic/methods
9.
Rev Stomatol Chir Maxillofac ; 112(3): 183-6, 2011 Jun.
Article in French | MEDLINE | ID: mdl-21497361

ABSTRACT

INTRODUCTION: Hyalinizing clear cell carcinoma (HCCC) of minor salivary glands (MSG) is a rare low-grade malignant neoplasm accounting for less than 1% of all salivary gland tumors. It usually affects the palate and the base of the tongue, and more rarely the parotid gland. We report a very rare maxillary localization. CASE REPORT: A 48-year-old male patient, without prior medical history, was referred to us for a painless gingival lesion of the right maxilla, extending from tooth 14 to 17, having appeared a few months before. The clinical examination was otherwise normal. Biopsy proved the diagnosis of HCCC. The CT scan revealed extension in maxillary sinus with bone osteolysis, and suspicion of cervical lymph nodes metastasis. The treatment was subtotal maxillectomy, cervical lymph node dissection, and postoperative radiotherapy because of incomplete bony resection. DISCUSSION: HCCC localization in the maxilla is extremely rare. This tumor may recur. The risk of metastasis is low; it concerns mainly lymph nodes. There is no treatment protocol consensus because the tumor is rare. Nevertheless, a wide local excision, with or without postoperative radiotherapy, seems to be the gold standard treatment.


Subject(s)
Adenocarcinoma, Clear Cell/diagnosis , Gingival Neoplasms/diagnosis , Maxillary Neoplasms/diagnosis , Biopsy , Follow-Up Studies , Humans , Male , Maxillary Diseases/diagnosis , Maxillary Sinus Neoplasms/diagnosis , Middle Aged , Neoadjuvant Therapy , Neoplasm Invasiveness , Osteolysis/diagnosis , Tomography, X-Ray Computed
10.
Rev Stomatol Chir Maxillofac ; 110(1): 45-9, 2009 Feb.
Article in French | MEDLINE | ID: mdl-19084247

ABSTRACT

INTRODUCTION: Epitheloid hemangioendothelioma is a rare vascular tumor with a borderline malignancy and a potential risk for recurrence. It usually affects the soft tissue of extremities, the liver, and the lungs. The cervicofacial localization is rare. We report a very rare maxillary localization. CASE REPORT: An 8-year-old girl with no personal or family history was sent to us by her dentist for a painless ulceration of the right maxilla having developed months before. There was no cervicofacial lymphadenopathy. The orthopantomography was normal. CT scan revealed palatine osteolysis under the ulceration. Biopsy proved the diagnosis of an epitheloid hemangioendothelioma. Screening for metastases was negative. The final treatment was partial maxilectomy 11 months later. No sign of locoregional recurrence was observed. DISCUSSION: Twenty-six cases of oral epitheloid hemangioendothelioma have been reported. The localizations are mostly gingival and lingual. The gingival localization is more frequent in children. The small number of reported cases does not allow determining the risk of locoregional recurrence or metastasis. There is no consensus on treatment. Like other authors, we suggest performing a wide local excision and careful follow-up.


Subject(s)
Hemangioendothelioma, Epithelioid/pathology , Maxillary Neoplasms/pathology , Child , Female , Humans
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