Positional changes of maxillary central incisors following orthodontic treatment using single-crown implants as fixed reference markers.

OBJECTIVES: This follow-up study (1) compares tooth displacement of central incisors in patients with and without pre-implant orthodontic treatment and (2) investigates whether sex, age, or orthodontic retention have an effect on tooth displacement after the insertion of single-crown implants. MATERIALS AND METHODS: Fifty-seven patients - thirty-seven with (test group) and twenty without pre-implant orthodontic treatment (control group) - were rehabilitated with 89 single-crown implants in the upper maxilla. Clinical and radiographic data, clinical photographs, and dental casts were collected during baseline examinations after prosthetic rehabilitation and at the final follow-up examination at least 5 years later. A total of 114 dental casts were digitalized and aligned using a software program to measure changes in the positions of the central incisors. RESULTS: After a follow-up period of at least five years, 87% of the central incisors measured in the test group were displaced >0.25 mm vertically compared with 70% in the control group. Seventy-eight percent of the test group teeth had moved >0.25 mm horizontally compared with 55% in the control group. These differences were not significant, and there were no significant correlations with patient age or sex. CONCLUSION: The majority of patients had minor vertical (60%) or horizontal (67%) tooth displacement of the central incisors (0.25-0.75 mm) after a minimum follow-up period of 5 years. This study found no significant differences in tooth displacement comparing patients with and without pre-implant orthodontic treatment. No significant effect of sex, age, orthodontic retention, or implant location was observed on tooth displacement.

L'ectopie des glandes parathyroides dans la chirurgie de l'hyperparathyroidie

Introduction : L'ectopie parathyroidienne est la cause d'echec la plus frequente de la chirurgie de l'hyperparathyroidie; entrainant le plus souvent des reprises chirurgicales. Son diagnostic topographique pre-operatoire reste difficile malgre le progres dans les differentes explorations radiologiques. Le diagnostic per-operatoire doit etre guide par une strategie de dissection de reference. Le but de travail est d'etudier la strategie de recherche des parathyroides lors de leur chirurgie. Materiels et methodes : Il s'agit d'une etude retrospective a propos de 137 patients (162 glandes parathyroides ectopiques) parmi 572 patients operes d'une hyperparathyroidie; colliges sur une periode de 11 ans (Janvier 2001-Decembre 2011). Tous les patients ont beneficie d'une imagerie pre-operatoire et ont ete operes sous anesthesie generale. Resultats : L'age moyen etait de 49 ans (11-71 ans) et le sex-ratio de 1;04. Une hyperparathyroidie primaire etait presente chez 26 patients (18;98) et une hyperparathyroidie secondaire a une insuffisance renale chronique chez 111 patients (81;02).Une cervicotomie par voie classique avec exploration des 2 loges thyroidiennes a ete realisee dans 136 cas. Dans les cas ou la parathyroide n'a pas ete retrouvee; un geste operatoire a ete associe. Ce geste consistait en un curage mediastino-recurrentiel (15 cas); une thymectomie (12 cas) et une lobectomie thyroidienne (9 cas). Un seul patient a eu une thoracotomie en chirurgie thoracique; sans abord cervical classique. Sur les 162 glandes parathyroides ectopiques retenues dans l'etude; 68 etaient des glandes parathyroides inferieures. Les localisations de celles-ci etaient par ordre de frequence le thymus (26 cas); le ligament thyro-thymique (14 cas); le mediastin antero-superieur (5 cas) et la gaine carotidienne (3 cas). Vingt glandes parathyroides inferieures n'ont pas ete retrouvees sur les 68 (29;41). Le nombre des glandes parathyroides superieures ectopiques etait de 94 sur 162. Leurs localisations etaient par ordre de frequence le pole superieur (33 cas); le pedicule superieur (20 cas); la region retro-oesophagienne (15 cas); la gaine carotidienne (11 cas); intra-thyroidienne (5 cas) et le mediastin postero-superieur (2 cas). Huit glandes parathyroides superieures n'ont pas ete trouvees sur les 94 (8;51). Au total; sur les 162 glandes parathyroides ectopiques; 28 n'ont pas ete retrouvees (17;28). Conclusion : L'imagerie est un moyen incontournable a la recherche d'une glande parathyroide ectopique. Lorsqu'elle n'est pas retrouvee dans sa localisation habituelle; la strategie de dissection chirurgicale doit etre methodique

[Unusual presentation of pulmonary alveolar proteinosis]. / Lipoprotéinose alvéolaire pulmonaire de présentation inhabituelle.

Pulmonary alveolar proteinosis is a rare disease characterized by the accumulation of granular lipoproteinaceous material within the alveoli; the interstitium is preserved. We report the case of a 27-year-old patient hospitalized for exploration of asymptomatic bilateral interstitial syndrome. Neither the radiographic signs nor the aspect of bronchoalveolar lavage was typical. The diagnosis was confirmed by pathology examination of surgical lung biopsy specimen which revealed lesions of interstitial fibrosis and cholesterol granulomas in association with pulmonary alveolar proteinosis. Since there was no functional deterioration, therapeutic abstention was decided.

[Pelvic hydatic echinococcosis in women in the maternity ward at the Habib Thameur University Hospital. Apropos of 5 cases (1978-1982)]. / L'échinococcose hydatique pelvienne chez la femme à la maternité du C.H.U. Habib Thameur. A propos de 5 cas (1978-1982).

We report 5 cases of pelvic hydatic cysts in women seen between 1978 and 1982. Hydatic disease is endemic in Tunisia, in spite of attempts to eliminate it, and these attempts are being improved. The plague persists because of certain inbuilt customs and because sheep are normally raised by small-scale production methods. The incidence of pelvic hydatic cyst disease is 2% of pelvic tumours seen in our maternity department over 5 years. The diagnosis was made easily preoperatively in only 2 cases, and it was in those 2 cases because of a previous history of hydatid disease. Ultrasound and electrosyneretic testing for hydatid cyst confirm the diagnosis. In the other cases the diagnosis was only made during the operation. In only one case had hysterosalpingography shown an impression on the right side of the uterus and a displaced right tube. The treatment must be surgical; and the outlook is good, except in one case where there was a recurrence. Post-operative follow-up consists of pelvic ultrasound and electro-syneresis as well as a general supervision of the patient's general state of health. At present we are accustomed to thinking of hydatid cysts when confronted with a pelvic tumour in a woman who comes from a region where the condition is endemic, whether she has or does not have any previous history of hydatid disease. The diagnosis is confirmed by ultrasound and electrosyneresis. Prophylaxis is always worthwhile.