Multicenter double-blind study of the efficacy and tolerance of roxithromycin versus erythromycin ethylsuccinate in acute orodental infection in adults. Odontogenic Infections Study Group.

A total of 194 patients with orodental infection were randomized either to roxithromycin 150 mg twice daily plus placebo or to erythromycin 1 g twice daily plus placebo for a mean duration of 8 days. The infections consisted of cellulitis, pericoronitis, and adenopathy, or any two in combination. In the 176 cases in which efficacy was evaluable, outcome was satisfactory in 94% and 91% of cases treated with roxithromycin and erythromycin, respectively (p = 0.45). Patients were evenly distributed with respect to demographic characteristics, diagnosis, and concomitant treatment. Surgery was performed in 63%, primarily for abscess formation in cellulitis (p less than 0.001); 18% of patients with an abscess did not undergo surgery. The success rate was identical irrespective of whether surgery was performed, including in those with an abscess. Tolerance was evaluated in 1986 patients. Unwanted effects, elicited by direct questioning, were reported in approximately 20% of cases per group (19% for roxithromycin and 21% for erythromycin). They consisted of mild gastrointestinal upsets which caused treatment to be withdrawn in eight cases (four per group). Thus, roxithromycin and erythromycin twice daily for orodental infection are similar in both efficacy and tolerance.

[Occurrence of post-traumatic temporo-mandibular ankylosis. Trial of classification of anatomo-pathologic lesions]. / Naissance d'une ankylose temporo-mandibulaire post-traumatique. Essai de systématisation des lésions anatomo-pathologiques.

According to the authors, who have an 18-year experience, the treatment of temporomandibular ankylosis in children consists in the resection of the ankylosis block and of the corresponding neck of the condyle, along with the preservation of the capsule and articular disk and a dynamic blockade with the mouth open until the mandibular condyle is completely reconstructed. After witnessing the constitution of ankylosis in a child who was initially examined 3 weeks after the trauma, we were able to carry out a thorough clinicopathological examination of the areas of tissue characterizing incipient ankylosis, both in the condylar cartilage and in the underlying bone. The initial stage produces the progressive emergence of the bony surfaces, which then bear no cartilage. This is osteogenesis as well as cartilage resorption, as evidenced by the presence of neoformed Haversian canals at that level. This is a formal argument in favor of a systematic dynamic blockade with the mouth open in all cases of fresh condylar surface and the menisceal surface of the joint is the best way to prevent ankylosis or malunion.

[Dynamic bite block in fractures of the mandibular condyle and following surgery of temporomandibular ankylosis in children]. / Le blocage dynamique dans les fractures du condyle mandibulaire et dans les suites opératoires des ankyloses temporo-mandibulaires chez l'enfant.

Early mobilization is the rule in cases of fracture and temporomandibular joint surgery. When prematurely discontinued, it may sometimes prove insufficient to prevent temporomandibular ankylosis in the child. Blockade in the open-mouth position is in keeping with an important general orthopedic rule, i.e., immobilization of joint fractures in position of function (ankylosis is loss of function, and is reflected by the child's inability or limited capacity to open his/her mouth). Continued night wear of re-habilitation devices, once consolidation is acquired, affords active joint mobilization during meals that is sufficient owing to the strength of the elevator muscles (five times than of the depressors).

[Lingual-mandibular remodeling resection in prognathism]. / La résection modelante linguo-mandibulaire dans les promandibulies.

The combination of --hypoplastic upper jaw, with narrow soft palate, --glossoptosis (or low, propulsive tongue), associated with protrusion of lower jaw, is well known. Early, exclusively orthopedic management combines enlargement of the superior arcade; functional/postural re-education of the tongue. Surgical management comes in later; it associates modeling resection of the tongue intended to position the tongue against the palate, with Chevron's mandibular resection, suppression of the first premolar, and salvaging the mental nerve. This type of osteotomy is indicated whenever a 6 to 8 mm mandibular retrusion is required. Fixation is monomaxillar, via extemporaneous splinting, associated with low external cortical osteosynthesis. The latter allows for gain of motor activity as early as the second day post-surgery.

Estomatitis eritemato-aftoide de erupción: ¿primoinfección herpética? (trad) / Eruptive erythemato-aphthous stomatitis: herpetic primoinfection?

La estomatitis eritemato-aftoide parece bien debida a una localización del virus herpético a la mucosa bucal, en la ocasión de la erupción dentaria. Se trata de una estomatitis herpética de primoinfección en el niño joven pero puede tratarse de localización mucosa de este virus "de entrada" en el niño mayor (AU)

Estomatitis eritemato-aftoide de erupción: ¿primoinfección herpética? (trad) / Eruptive erythemato-aphthous stomatitis: herpetic primoinfection?

La estomatitis eritemato-aftoide parece bien debida a una localización del virus herpético a la mucosa bucal, en la ocasión de la erupción dentaria. Se trata de una estomatitis herpética de primoinfección en el niño joven pero puede tratarse de localización mucosa de este virus "de entrada" en el niño mayor

[Cauhépé-Fieux syndrome. Interception in the deciduous dentition of mid-face hypoplasia]. / A propos du "syndrome de Cauhépé-Fieux". L'interception en denture lactéale des hypoplasies de l'étage moyen.

Inadequate transverse development of the milk dentition alveolar arcade (Cauhepe-Fieux syndrome) may have important effects on the constitution of facial architecture and in the medium term require orthognathic surgery. The acquisition of dental arcade contact on deglutition is only possible after normalization of the dimensions of the arch of the palate. The recommended suture inducing prosthesis should obligatorily include intercalating molar plates designed to overcome inadequate occlusion during treatment (on average 9 months). Both stimulation of growth at the level of the intermaxillary suture in this age group, and the stability of the results obtained, have been demonstrated after a period of follow up of more than 10 years taking into account the cybernetic aspects of the studies carried out by Professor Petrovic.

[The systemic environment and dental development. From the clinical to the molecular approach]. / Environnement systémique et développement dentaire. De la clinique à l'approche moléculaire.

Clinical observation of patients with disordered phosphocalcium metabolism has demonstrated that dyschromia and/or dental dysplasias systematically accompany such disorders. A certain action of this steroid on dental buds has been demonstrated after analysis of the effects of experimental vitamin D deficiency in the rat: vitamin D would seem to control the behaviour of cells undergoing differentiation and also after this process is complete. Dentinogenesis and amelogenesis would appear principally to be affected. Two proteins, calbindins D-9K and -28K, may constitute the molecular mediators of this ameloblastic regulation.

[Genioplasty in adolescence]. / Les génioplasties de l'adolescent.

Different possible types of genioplasty in adolescence are envisaged: pure subtraction, conjugated subtraction, apposition, addition and in particular transfer for correction of the facial asymmetry of temporomandibular ankylosis sequelae. It is difficult to predict results and it is necessary to remain within a known framework in which esthetic and psychologic demands must occupy a very important place.

[Mandibular angle and orthodontic treatment. Apropos of the possible therapeutic inversion of the direction of rotation of mandibular growth]. / Angle mandibulaire et traitement orthopédique. A propos de l'inversion thérapeutique possible du sens de la rotation de croissance mandibulaire.

The spontaneous and therapeutic modifications of the mandibular angle suggest that the rotations of growth described by Björk are not inevitable but are due to lingual dysfunction, particularly involving the pharyngeal part. Adequate treatment can modify the widening and narrowing of this angle.

[Capdepont dysplasia and vertical excess of the lower half of the face. Genetic syndrome or fortuitous association?]. / Dysplasie de Capdepont et excès vertical de l'étage inférieur. Syndrome génétique ou association fortuite?

The study of an Algerian family revealed that four of the seven children presented dentinogenesis imperfecta associated with an anomaly of the facial skeleton (maxillary hypoplasia, anterior expansion of skeletal origin due to widening of the angle of the gonion). This type of association and its very unusual type of transmission (no doubt recessive) leads to a discussion of genetic mechanisms of these syndromes.

[Possibility of a relationship between the development of keratocysts of the maxilla and dental eruption]. / Possibilité d'une relation entre le développement de kérato-kystes des maxillaires et l'éruption dentaire.

On the basis of two cases, the problem is raised of the pathogenesis of kerato-cysts. The possibility of some sort of "induction" by factors which are involved in provoking eruption of the teeth is suggested by the clinical cases described.