Fractures mandibulaires : prise en charge par procédés orthopédiques et prothétiques

Les fractures mandibulaires sont une solution brutale et accidentelle de la continuité complète ou incomplète, avec ou sans déplacement des fragments de la fracture de l'os mandibulaire. Elles ont un retentissement majeur d'ordre fonctionnel et morphologique, avec des complications plus ou moins graves en l'absence de traitement approprié. Il est donc important de faire une prise en charge rapide des patients traumatisés. Méthodes: La prise en charge de ces fractures relève de la chirurgie par mini-plaques d'ostéosynthèse et/ou des procédés orthopédiques et prothétiques. Les auteurs proposent, à travers un cas clinique, la prise en charge des fractures mandibulaires par procédés orthopédiques et prothétiques. Le procédé a consisté à construire et à poser une gouttière bivalve en résine acrylique pour réaliser une contention mandibulaire. Résultats: Le dispositif utilisé a permis de traiter efficacement le patient traumatisé. En outre, les fonctions de l'appareil manducateur et La morphologie des contours du visage ont été restaurées, permettant ainsi une meilleure insertion socio-professionnelle du patient. Discussion: Les procédés orthopédiques et prothétiques sont fréquemment utilisés du fait de leur coût relativement peu élevé par rapport la chirurgie réparatrice. Dans les cas de dents délabrées et d'appuis dentaires insuffisants, le choix de la gouttière bivalve en résine acrylique apparait comme la meilleure option thérapeutique. Conclusion: Dans notre contexte d'exercice caractérisé par des patients aux moyens financiers limités, la prise en charge des fractures mandibulaires par les procédés orthopédiques et prothétiques permet d'obtenir des résultats comparables à la chirurgie réparatrice

[Factors of failure of prosthetic restoration of the acquired losses of substance of the jawbone and the mandible in sub-Saharan Africa]. / Facteurs d'échec de la restauration prothétique des pertes de substances maxillaires et mandibulaires acquises en Afrique subsaharienne.

The obturating prostheses of the jawbone and the prostheses of rebuilding of the mandible make it possible to restore the losses of substance of the jawbone and of the mandible and to cure the functional and Aesthetic disorders which result from these losses of substance. The success of these prosthetic restorations can be compromised by technical, economic and cultural factors. The principal factors are the importance of the losses of substance, the reduced number of teeth, the poverty of the technical plate, the persistence of certain traditional concepts. The fight against these factors requires the promotion of therapeutic associations in maxillo-facial cancerology, the sensitizing of the populations to the early hospital consultations, the improvement of the technical plate of the prosthesis of the jawbone and the face, the facilitation of the access of the most underprivileged groups to the prosthetic restorations, the promotion of multi-field collaboration, the whole co-operation of the patient throughout the treatment and the follow-up postprothetic.

[Influence of food quality and quantity on children's teeth]. / Influence de la qualité et de la quantité de l'alimentation sur les dents chez l'enfant.

Sugar and tooth decays are bound closely. The mechanisms of destruction of the tooth from the glycolyse are known. The role played by the food in the development of the caries is unique. Foods sweetened of all ways, rich in sucrose are responsible of the intervening of the carious lesions. The transformation of the fermentable sugars in lactic with the absence of hygiene and the action conjugated of the bacteria leads to tooth decays in temporary and permanent denture that evolve very quickly in the absence of treatment. Reasons for which the authors put in evidence in this survey, the influence of the food sweetened on the teeth at the children while showing the cases of caries and its complications due to the excessive consumption of fermentable hydrates of carbon.

[Replacement of deciduous incisors in children: psychological aspects]. / Remplacement des incisives temporaires chez l'enfant: intérêt psychologique.

The absence of the temporary incisors could be to a genetic illness or to some multiple premature extractions. These extractions are the aftermaths of the carious lesions or some traumatisms underwent by the temporary incisors. Beyond measure the loss of the space, the premature loss some temporary incisors very often assign the relational development of the child and disturb its psychological development and the aesthetic function. Across some cases clinics, the authors show that the replacement of the temporary incisors is the therapeutic ideal solution. Indeed, the child prosthesis, replacing the temporary absent incisors, solves the psychological, aesthetic and relational problems of the child.

[Complications of injuries to deciduous teeth]. / Complications des traumatismes des dents temporaires.

The traumatisms of the temporary teeth are very frequent. They are bound to the acquirement of the march, to the games, to the sport and to the accidents of the public way. Favoured by the presence one improved proalveoly, they constitute a dental emergency of makes some important risks of complications. Indeed, these traumatisms, in case of belated conference and/or of maladjusted treatment or conducted pain, could induce some complications and have some aesthetic and functional after effects on the dental germ underlying. Some of these complications observed in some patients are stakes in evidence by some iconographic illustrations.

[Therapeutic possibilities for multiple caries in children]. / Possibilites therapeutiques des polycaries chez l'enfant.

The exaggerated consumption of sugars under its various associate shapes to an insufficiency of mouth and tooth hygiene could drag some tooth decays. These tooth decays, when they demonstrate, leads to a destruction of the temporary teeth, with for corollaries of the aesthetic and functional problems. The therapeutic are not always apparent especially when there is coexistence of coronary destruction to juxtapose to the gum without reaching pulp with some precocious a toothlessing. The authors, across some cases clinics treated to the breast of service of Paediatric Dentistry shows different types of therapeutic possibilities in function of the shapes clinics. He was about conservative treatments or of extraction, of prothesis restorations to the aide of the Crown order form, of infantile removable prosthesis and of composite prosthesis.

[Treatment of protruding upper incisors using the Hawley appliance]. / Le traitement de la proalveolie incisive superieure par la plaque de Hawley.

Early treatment of upper protrused incisors prevents these teeth from traumatism. The plate of HAWLEY, properly used, is recognised for the correction of this malocclusion.