Avec l’augmentation de l’espérance de vie et la population mondiale vieillissante, le praticien est souvent amené à renouveler les anciennes prothèses complètes de ses patients. Il est alors souvent ...confronté à un ensemble de perturbations qui compliquent l’abord des cas ainsi que le pronostic du traitement ; l’attachement affectif des patients à leur prothèses, l’inflammation douloureuse des surfaces d’appui, quasiment constante, induit par attitude antalgique, un appui occlusal hésitant et une stabilité prothétique improbable. Les tensions musculaires et/ou perturbations articulaires accompagnent souvent une occlusion décentrée à une DVO sous évaluée et un relief cuspidien effacé. La détermination immédiate d’un rapport intermaxillaire stable et répétitif devient alors illusoire. Le recours à la prothèse transitoire permet d’évaluer la possibilité de retour des structures d’appui à un état de santé tout en optimisant le traitement en terme de confort, de prédictibilité et d’engagement de la part du patient. L’objectif de ce travail est de passer en revue, à travers un cas clinique, l’attitude clinique à adopter dans les thérapeutiques de remise en condition, tout en mettant l’accent sur l’intérêt de la prothèse transitoire dans cette approche.
With the increasing life expectancy and the aging world population, often, dentists have to renew their patients old complete dentures. Then, they find themselves confronted to plenty of troubles that complicate the approach and the prognosis of the treatment; such as emotional attachment of the patients to their prostheses. Also painful inflammation of the support surfaces, almost constantly, leads to an analgesic attitude, inducing a hesitant occlusal support and an unlikely prosthetic stability. Muscle and / or joint disturbances often go with a non-centered occlusion, an undervaluated vertical dimension and deleted cusp embossing. Trying immediately to fix a steady and repetitive jaw relationship becomes delusive. The use of transitional prosthesis helps evaluating the possibility to find back healthy support structures while optimizing the treatment in terms of comfort, predictability and commitment from the patient. The objective of this work is to review, through a case report, the clinical attitude to adopt in reconditioning therapy, and highlight the interest of the transitional prosthesis in this approach.
L'équilibre du système masticateur est une priorité aux yeux de tout praticien occluso-conscient, et nécessite la restauration d'un guidage antérieur fonctionnel et protecteur. Cet objectif ne peut ...être atteint que par l'examen et le diagnostic des rapports occlusaux antérieurs par comparaison à un modèle académique de référence. L'attitude thérapeutique adoptée sera modulée en fonction des données recueillies et fait appel à l'intégration, la recopie ou la recréation du guidage. Quelle que soit la séquence thérapeutique, la validation des paramètres de guidage par des prothèses provisoires, durant une phase de temporisation et la retranscription de ces données sur les prothèses définitives sont les seuls garants de l'intégration prothétique. Ce travail se propose, de mettre en évidence l'intérêt d'un guide antérieur fonctionnel et les moyens d'y parvenir dans le cadre d'une restauration prothétique par prothèse fixée.
The masticatory system balance is crucial for any occlusion-conscious physician. It requires the restauration of a functional and protective anterior guidance. This goal cannot be reached without the examination and diagnosis of previous occlusal relations compared to a reference academic model. The therapeutical pattern will be modulated based on gathered information, and requires the integration, or the regeneration of the guidance. Whatever the sequence of the treatment is, the validation of the guidance parameters through temporary prostheses, during the temporizing and transcripting phase of the data on the permanent prosthesis, is the only way to assure a prosthetic integration. This work outlines the benefits of a functional anterior guidance and the different ways to realize it based on a prosthetic restauration through a fixed prostheses.
RapidArc is an “IMRT Arc therapy” using a single rotation of the linac gantry to deliver a precise IMRT plan following IGRT and OBI targeting. This “volumetric arc,” often labeled VMAT, for ...Volumetric Arc Therapy, enhances both the delivery and the targeting of prostate cancer radiation. The object if of this study was to compare VMAT prostate RT plans with three-dimensional conformal RT (3D-CRT) in terms of the clinical target volume PTV and the organs at risk OAR
Background
HPV tests for the screening of cervical cancer in low‐income countries (LICs) might improve early detection and preventive efforts.
Objectives
To determine the diagnostic accuracy of HPV ...tests for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN 2+) in LICs.
Search strategy
The Cochrane Library, MEDLINE, and CINAHL databases were searched on June 1, 2020. References of relevant studies were hand‐searched.
Selection criteria
Diagnostic test accuracy studies were included if women had an HPV test for cervical cancer screening, followed by verification with colposcopy and colposcopy‐directed biopsy. The primary target was CIN2+.
Data collection and analysis
Two authors independently screened studies, extracted data, and assessed methodological quality. Bivariate diagnostic random‐effects meta‐analysis was used.
Main results
Eleven studies including 82 556 women were eligible, most of which were at low risk of bias. The pooled diagnostic odds ratio of hybrid capture test of samples collected from the cervix by healthcare providers for detecting CIN2+ and CIN3+ was 42.0 (95% confidence interval CI 20.7–76.3) and 97.1 (95% CI 35.3–215.0), respectively.
Conclusions
Evidence indicates that hybrid capture tests can be used for screening of cervical cancer in LICs. Future studies are warranted for self‐sampling and for low‐cost HPV tests.
Testing for HPV has a potential role in the screening of cervical cancer in low‐resource settings.
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