French Otorhinolaryngology Society (SFORL) good practice guidelines for dental implant surgery close to the maxillary sinus.

OBJECTIVES: To draw up guidelines for ENT management associated with dental implant surgery with or without sinus lift. MATERIALS AND METHODS: The methodology followed the rules of laid down by the French Health Authority (HAS): "Methodological bases for drawing up professional recommendations by formalized consensus". The chosen method was the RAND/UCLA "RAND appropriateness method" (short version). RESULTS: In the pre-implantation check-up, it is recommended to systematically screen for sinonasal pathology on medical interview and to favor 3D CT or cone-beam imaging. It is recommended that imaging include the entire maxillary sinus when the patient does not have sinonasal history or functional signs on interview. Otherwise, examination of all sinonasal cavities is recommended. This attitude enables simultaneous analysis of maxillary infrastructure for pre-implantation work-up and assessment of sinonasal cavity status. Sinus mucosal incidentalomas are very common in the healthy population and must be assessed with reference to the clinical, endoscopic and radiological context. CONCLUSION: This formalized expert consensus establishes a common base of knowledge, to clarify the issues and clinical situations and to standardize practices.

[218 tooth extraction in patients taking platelet aggregation inhibitors]. / Antiagrégant plaquettaire et chirurgie buccale: à propos de 218 extractions dentaires.

INTRODUCTION: The aim of this survey was to show that tooth extraction could be performed in patients taking antiplatelet agents. The main indication of antiplatelet agents is to reduce the thrombotic disease. MATERIAL AND METHOD: The authors made a descriptive and retrospective analysis of 52 patients taking antiplatelet agents in their department between February 2003 and January 2005. Two hundred and eighteen tooth extractions were performed. For each extraction, a protocol of local hemostasis (filling, suture, compression) was applied. RESULTS: Three hemorrhagic sockets were reported out of 218 extractions performed without stopping the antiplatelet agent treatment (1.3%). One patient presented with persistent bleeding out of 52 cases (1.9%). No hemostasis had been performed on this patient; a local hemostasis was performed during surgical revision, which stopped the persistent bleeding. DISCUSSION: These results show that the hemorrhagic risk can be controlled by a local hemostasis protocol.

[Survey of focal infection in a hospital environment]. / Enquête sur l'infection focale en milieu hospitalier.

To make their study the authors inquired in the different departments of the University Hospital in Rennes, concerned by the problem of focal infection. This study aims at helping practitioners to take the right therapeutic decision in case of high, low or non existent infection risks. The results of the study show new pathologies involving focal infection risks. The evaluation of the patient's examination will be made by the service the patient comes from, and the Odonto-Stomatologist; the decision will be taken in common and according to the severity, the evolution, and the possible recurring of the disease.