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Objective To analyse the accuracy of a meta-analysis-based dental age assessment (DAA) method in Finnish paediatric patients and to compare the dental development between two generations of Finnish children. Methods Panoramic radiographs of Finnish Caucasian healthy children from two generations (early: born 1981–1984; subsequent: born 1996–2008) were analysed. All developing teeth on the left maxilla and mandible as well as the third permanent molars were analysed following Demirjian’s classification. For each patient, dental age was calculated and compared with chronological age. Dental maturation patterns between the two groups were compared. Results The study included 200 Finnish Caucasian healthy children from two generations (early: aged 7–13 years; subsequent: aged 6–15 years). In the early generation, DAA underestimated the chronological age by a mean of 3.15 years. The underestimation was only 0.11 years in patients Conclusions The present DAA method is applicable to current Finnish children. Differences in dental development between two generations of Finnish children were detected.

Objective: To compare near infrared transillumination device, DIAGNOcam (DC) and bitewing radiography (BW) for the detection of proximal caries. Materials and methods: This retrospective analysis of DC and BW images of 18 students in dental medicine who had consented to the anonymous use of their dental record. The data included BW and DC images performed for a check-up in 2013, and corresponding follow-up images performed in 2015. Two observers rated 376 proximal surfaces on a 4-level dentin lesion scale and reached a unanimous rating for each surface. Calculated measures of agreement for each assessment method over time provided the reproducibility of the information obtained by each method. Results: Agreement between 2013 and 2015 within each method was excellent (intraclass correlation coefficient, BW: 0.86, DC: 0.90). Agreement between DC and BW was similar for dentin lesion detection, but was low for enamel caries detection; DC detected more enamel caries than BW. Agreement between DC and BW was modest (0.33 in 2013 and 0.36 in 2015), chiefly because DC identified more enamel caries. Conclusion: This study shows that DC is as reliable as BW to detect proximal dentin lesions. DC detects proximal enamel lesions at an earlier stage than BW. DC enables clinicians to differentiate lesions limited to the enamel from lesions that have reached the enamel dentin junction. Regular monitoring with DC should help provide individualized preventive measures and early non-invasive caries management. Clinical significance: The early detection of enamel lesions with near infrared transillumination can help clinicians undertake early non invasive treatments to prevent or slow down the progression of initial proximal lesions.

This preclinical in vitro study compared the accuracy of implant lengths measured in two different image-viewers, and examined whether implant-induced artifacts affected the implant length measurements on CBCT images. A resin edentulous mandibular model, with multiple adjacent implants in the posterior segments, was acquired with a CBCT machine. In two different image-viewers, two observers independently measured the implant length. Vertical measurements on CBCT images were carried out twice at each session, and repeated one week later. The results demonstrated no significant differences between actual and measured implant lengths. The differences in the mean error for vertical measurements using the two different image-viewers (cross-sectional images: OsiriX viewer = -0.01 ± 0.03 mm, NewTom viewer = -0.05 ± 0.09 mm, p-value = 0.056; sagittal images: OsiriX viewer = -0.03 ± 0.04 mm; NewTom viewer = -0.04 ± 0.10 mm, p-value = 0.24) were not statistically significant. This in vitro investigation suggests that the accuracy of implant length measurements on CBCT images was not influenced by image-viewers or by the presence of implant-induced artifacts. The presence of multiple adjacent implants in the posterior segments of the mandible is not likely to impact the measurements made between the implant apex and vital structures on CBCT images.

francaisMarie-Jeanne Roland est guillotinee le 8 novembre 1793. « Femme forte » du gouvernement Roland dirige par son mari, elle ecrit en prison des Memoires particuliers et des Notices historiques, en attendant « l’honneur d’aller a l’echafaud ». Temoignage unique d’une femme qui ecrit sous le signe de la verite, se sachant condamnee. Temoignage forge sous le signe du paradoxe car, tout en se declarant innocente face aux accusations de ses bourreaux, car elle « n’est qu’une femme », elle s’affirme superieure a ces « etres pusillanimes », ces « hommes qui n’en meritent pas le nom » et qui dirigent la destinee des Francais en cette periode de terreur. EnglishMarie-Jeanne Roland is guillotined on November 8th, 1793. “Strongwoman” of the Roland government directed by her husband, she writes her Memoires particuliers and some Notices historiques in prison, waiting for “the honor to mount the scaffold”. A unique testimony of a woman who writes under the sign of truth, as she knew she was condemned. A testimony formed under the sign of paradox because, while claiming herself innocent of the accusations leveled against her by her executioners, since she “is just a woman”, she asserts her superiority in front of these “faint-hearted beings”, these beings “who do not deserve the name of men” and who rule the fate of the French in this era of terror.

The study aims to evaluate the long-term efficiency of the procedure and stability of the peri-implant bone formed following implant placement without grafting into resorbed posterior maxilla.

PURPOSE To describe the survival rate and peri-implant bone loss in very old patients dependent for their activities of daily living (ADL), treated with mandibular two-implant overdentures (IODs) in the context of a previously reported randomized controlled trial. MATERIALS AND METHODS A total of 19 patients received two interforaminal Straumann implants (Regular Neck, 4.1 mm diameter, 8 mm length) that were subsequently loaded with Locator attachments, transforming their preexisting inferior conventional denture into an IOD. The primary outcome measures were implant survival rate and radiographically assessed peri-implant bone loss. Secondary outcome measures included peri-implant probing depth and Plaque Index scores, as well as implant mobility. Nutritional state (body mass index and blood markers) and cognitive state (Mini-Mental State Examination) were also analyzed. RESULTS The patient cohort comprised eight men and 11 women with a mean age of 85.7 ± 6.6 years. The implant survival rate up to 5 years was 94.7%, with one early and one late implant failure. The mean loss of peri-implant bone height was 0.17 mm per year (95% confidence interval: 0.09 to 0.24; P < .001). Peri-implant probing depth and Plaque Index scores were low and stable during the first 2 years, and thereafter increased continuously. Correlation analysis suggests that a reduced cognitive function and nutritional state are not a particular risk factor for accelerated peri-implant bone loss. CONCLUSION The high implant survival and acceptable peri-implant health suggest that neither age nor dependency for the ADLs is a contraindication for the placement of implants. Nevertheless, close monitoring of the patients concerning a potential further functional decline precluding denture management and performing oral hygiene measures is advised.

The purpose of this study was (1) to investigate denture satisfaction following the conversion of existing mandibular complete dentures to implant overdentures (IOD) in very old edentulous patients who depend on help for activities of daily living and (2) to evaluate secondary end points, such as functional, structural, nutritional, and patient-centered aspects. For this randomized clinical trial, 2 interforaminal short implants were placed in the intervention group ( n = 16, 85.0 ± 6.19 yrs) to retain mandibular IODs; the control group ( n = 18, 84.1 ± 5.55 yrs) received conventional relines. During the first year, no implant was lost; however, 2 patients died. IODs proved more stable, and participants in the intervention group demonstrated significantly higher denture satisfaction as well as an increased oral health–related quality of life compared to the control group. Maximum voluntary bite force improved significantly with IODs, yet the chewing efficiency was not different between groups. Masseter muscle thickness increased with IODs, mainly on the preferred chewing side. Body mass index decreased in both groups, but the decline tended to be smaller in the intervention group; blood markers and the Mini Nutritional Assessment did not confirm this tendency. These results indicate that edentulous patients who depend on help for activities of daily living may benefit from IODs even late in life (ClinicalTrial.gov NCT01928004).

Panoramic radiographs allow evaluation of the available bone height for implant treatment planning while imparting a low radiation dose. As panoramic radiography produces image distortion, reference objects are required to determine the exact magnification. This study aims to estimate a panoramic unit's vertical magnification factor (MF) by measuring the length of dental implants used as radiopaque reference objects on postoperative panoramic radiographs. We compared our findings to the vertical MF listed by the panoramic unit manufacturer, and studied the reproducibility and accuracy of our measuring method by analyzing the inter- and intraobserver agreements.

Nedir R, Nurdin N, Vazquez L, Szmukler-Moncler S, Bischof M, Bernard J-P. Osteotome sinus floor elevation technique without grafting: a 5-year prospective study. J Clin Peridontol 2010; 37: 1023–1028. doi: 10.1111/j.1600-051X.2010.01610.x. Abstract Aim: To evaluate the long-term stability of peri-implant bone formation following implant placement without grafting into resorbed posterior maxillae. Materials and Methods: Twenty-five implants of 10 mm were placed in 17 patients to rehabilitate atrophic maxillae by means of an osteotome sinus floor elevation (OSFE) procedure without grafting. Mean residual bone height was 5.4±2.3 mm. Bone levels were evaluated at 1, 3 and 5 years using periapical radiographs. Results: All implants fulfilled survival criteria and gained peri-implant bone (mean increase 3.2±1.3 mm). Implant protrusion into the sinus decreased from 4.9±1.9 mm after surgery to 1.5±0.9 mm after 5 years. Mean crestal bone loss amounting to 0.8±0.8 mm stabilized over the 5-year observation interval. Twenty implants showed additional peri-implant bone gain following the 1-year control. Conclusions: Implant rehabilitation of atrophic maxillae may be greatly simplified using implants 10 mm and the OSFE technique without grafting. Grafting material is not needed to gain at least 3 mm of bone in the atrophic maxilla. The procedure appears predictable with favourable long-term results.

Objectives.The purpose of this panoramic radiography study was to assess the impact of image magnification on the accuracy of vertical measurements in the posterior mandible.Methods.Six dental implants, inserted in the posterior segments of a resin model, were used as reference objects. Two observers performed implant length measurements using a proprietary viewer with two preset image magnifications: the low (1.9 : 1) and the medium (3.4 : 1) image magnifications. They also measured the implant lengths in two Digital Imaging Communications in Medicine viewers set at low (1.9 : 1), medium (3.4 : 1), and high (10 : 1) image magnifications.Results.The error between the measured length and the real implant length was close to zero for all three viewers and image magnifications. The percentage of measurements equal to the real implant length was the highest (83.3%) for the high image magnification and below 30% for all viewers with the low image magnification.Conclusions.The high and medium image magnifications used in this study allowed accurate vertical measurements, with all three imaging programs, in the posterior segments of a mandibular model. This study suggests that a low image magnification should not be used for vertical measurements on digital panoramic radiographs when planning an implant in the posterior mandible.

Dental age assessment methods are widely used for age estimation. This study aimed to analyse the accuracy of a meta-analysis method to estimate dental age in Swiss individuals and to detect potential limitations of the method. Precision of repeated tooth staging using Demirjian's classification on maxillary and mandibular teeth was also assessed.Panoramic radiographs of 50 Swiss white healthy children were analysed. Developing teeth on the left maxilla and mandible and all third permanent molars were staged following Demirjian's classification. Dental age was calculated for each subject, using a random effects model and a fixed effect model, and compared with chronological age.The mean error of the dental age ranged between -3 and +1 months for both the calculation models. Dental age calculated with the fixed effect model overestimated the age of the subjects (average + 0.10 y, ranging from -1.95 y to +2.16 y) compared with their chronological age, whereas the random effects model underestimated the age (average -0.32 y, ranging from -2.24 y to +1.61 y).Demirjian's method allowed a precise repeated staging of maxillary and mandibular developing teeth. For both calculation models, dental age correlated well, on average, with chronological age of Swiss subjects younger than 12 years. The random effects model showed a better accuracy for these subjects than the fixed effect model. However, both models underestimated the chronological age in subjects older than 12 years.

Objective Currently, practitioners use clinical and histopathologic examination to diagnose a caliber-persistent labial artery (CPLA). We illustrate the use of ultrasonography as a noninvasive diagnostic tool to visualize this enlarged artery of the lip. Methods We examined the lips of 3 patients with a suspected CPLA. We localized and determined the extension of the intralabial artery with ultrasonography, including pulsed and color Doppler analysis. We compared the sonograms to the clinical and histopathologic findings. Results Sonograms showed clear enlargement of the labial artery in the 3 cases. The course of the constant-diameter artery was either vertical or oblique from the depth of the lip to the surface of the mucosa. This vascular abnormality was confirmed by histopathologic examination. Conclusions Ultrasonography and color Doppler imaging may be useful noninvasive tools for the diagnosis and preoperative evaluation, as well as the follow-up, of labial lesions related to a CPLA, thus eliminating the need for diagnostic surgery in typical pulsatile nodules. Ultrasonography may help distinguish a CPLA from other vascular lesions of the lip such as an aneurysm. Atypical cases or chronic ulcerations mimicking a cancer should undergo biopsy so that a malignant process is not missed.

Summary Recent studies have shown significant progress in improving the quality of care for asthma. The most successful interventions have combined multiple elements: educational sessions that engage learners in discussing cases and practicing new skills; use of new resources, tools and practice patterns to enable quality improvement; and reinforcement of improvements through peer support, incentives or administrative review. Future research should include more randomised controlled trials to test the effectiveness of quality improvement interventions, more detailed descriptions of strategies to change health professional behaviour and studies to determine whether effective interventions can be translated to other settings, disseminated widely and sustained over time.

The anchorage of machined Branemark and ITI TPS-coated implants of various lengths was investigated in an animal model. Branemark fixtures 7 and 10 mm long and ITI implants 6 and 10 mm long were inserted in the mandible of dogs and were reverse-torqued after 3 months of healing. The failing mode was different for the two implant systems. For the ITI implants, loosening coincided with the peak reverse-torque values. For the Branemark fixtures, two reverse-torque values were identified and recorded, a ‘start to rotate’ and a peak value. The ‘start to rotate’ values for the 7 and 10 mm Branemark fixtures were 36.67 and 38.57 Ncm, respectively, the peak values were 61.88 and 69.13 Ncm. The increase in implant length from 7 to 10 mm did not significantly improve the anchorage. The mean reverse-torque values for the 6- and 10-mm ITI implants were 104.66 and 192.25 Ncm, respectively; the difference was statistically significant. The mean removal torque of the 6-mm ITI implant was higher than the 7- and 10-mm Branemark implants. It is suggested that the distinct anchorage magnitude and the distinct loosening patterns registered for both implant systems might be related to the various surface states. The latter might account for the different failure tendencies mentioned in the literature for short Branemark and ITI implants.

Dental implants are commonly used in daily practice; however, most surgeons do not really know the characteristics of these biomedical devices they are placing in their patients. The objective of this work is to describe the chemical and morphological characteristics of 14 implant surfaces available on the market and to establish a simple and clear identification (ID) card for all of them, following the classification procedure developed in the Dohan Ehrenfest et al (2010) Codification (DEC) system. Fourteen implant surfaces were characterized: TiUnite (Nobel Biocare), Ospol (Ospol), Kohno HRPS (Sweden & Martina), Osseospeed (AstraTech), Ankylos (Dentsply Friadent), MTX (Zimmer), Promote (Camlog), BTI Interna (Biotechnology Institute), EVL Plus (SERF), Twinkon Ref (Tekka), Ossean (Intra-Lock), NanoTite (Biomet 3I), SLActive (ITI Straumann), Integra-CP/NanoTite (Bicon). Three samples of each implant were analyzed. Superficial chemical composition was analyzed using X-ray photoelectron spectroscopy/electron spectroscopy for chemical analysis, and the 100 nm in-depth profile was established using Auger electron spectroscopy. The microtopography was quantified using light interferometry. The general morphology and nanotopography were evaluated using a field emission-scanning electron microscope. Finally, the characterization code of each surface was established using the DEC system, and the main characteristics of each surface were summarized in a reader-friendly ID card. From a chemical standpoint, of the 14 different surfaces, 10 were based on a commercially pure titanium (grade 2 or 4), 3 on a titanium-aluminum alloy (grade 5 titanium), and one on a calcium phosphate core. Nine surfaces presented different forms of chemical impregnation or discontinuous coating of the titanium core, and 3 surfaces were covered with residual aluminablasting particles. Twelve surfaces presented different degrees of inorganic pollutions, and 2 presented a severe organic pollution overcoat. Only 2 surfaces presented no pollution (Osseospeed and Ossean). From a morphological standpoint, 2 surfaces were microporous (anodization) and 12 were microrough, with different microtopographical aspects and values. Ten surfaces were smooth on the nanoscale, and therefore presented no significant and repetitive nanostructures. Four implants were nanomodified: 2 implants were nanorough (Osseospeed and Ossean), and 2 were covered with nanoparticles (NanoTite and SLActive). TiUnite and Kohno HRPS were covered with extended cracks all over the surface. Only 8 surfaces could be considered homogeneous. This systematic approach allowed the main characteristics of these commercially available products to be gathered in a single ID card. It can be used as an experimental tool or a method for controlling industrial implant productions. The DEC system could be an interesting basis for the development of a clear and simple ISO standard for dental implant surfaces and other implantable devices.

Reconstruction after substantial osseous, cutaneous, and muscular tissue loss following a mandibular resection is a challenge. The use of a fibular free flap is an outstanding, but delicate, treatment option. These grafts, using the double-barrel technique, can achieve an almost complete reconstruction of the mandibular defect. The challenge posed by these treatments is to achieve an end result that is both functional and esthetically pleasing—an endeavor that requires a defined prosthetic plan prior to complete microsurgical reconstruction. Using a detailed clinical case, this article discusses the importance of planning the mandible reconstruction with double-barrel fibular graft in view of an implant-supported fixed partial denture. Immediate implant loading was even possible in this case. This approach allows improvement of the final esthetic and functional result of such a complex rehabilitation. Maxillofacial reconstructive surgery should seek to establish a near-as-normal anatomic situation that will allow a permanent implant rehabilitation that is both esthetic and durable.

Objective: In a prospective pilot study, short � 10mm ITI-SLA implants were placed in the resorbed posterior maxilla by means of an osteotome sinus floor elevation (OSFE) procedure without grafting material. This paper presents 3-year data assessing bone-level changes around implants. Material and methods: Twenty-five implants were placed in 17 patients to rehabilitate 16 molar and nine premolar sites. The mean residual bone height (RBH) was 5.4 � 2.3mm. A healing period of 3‐4 months was allowed before abutment tightening. Most implants (21/ 25) were 10mm long, and the others were 8 and 6mm long. At the 3-year control, endosinus bone gain, implant length protruding into the sinus and crestal bone loss (CBL) were measured on periapical radiographs. Results: All implants fulfilled the survival criteria. Despite the absence of grafting material, implants were embedded into newly formed bone tissue. All implants gained endo-sinus bone; the mean gained bone was 3.1 � 1.5mm. The residual protrusion length decreased from 4.9 � 2.1 to 1.8 � 2.1mm. CBL was 0.9 � 0.8mm. Conclusions: This study confirms that the OSFE procedure without grafting material is sufficient to create bone beyond the natural limit of the sinus. On the mid-term of 3 years, the technique was found to be predictable in the posterior maxilla when the RBH is limited. Implants gained endo-sinus bone despite the lack of grafting material. Bone gain was still improving over the first-year control. No shrinkage of the augmented area was observed. Poor residual bone height (RBH) in the posterior maxilla beneath the sinus is still ac hallenge for the oral implantologist. To recreate a sufficient volume of bone, var

OBJECTIVES: Various imaging techniques, including conventional radiography and computed tomography, are proposed to localize the mandibular canal prior to implant surgery. The aim of this study is to determine the incidence of altered mental nerve sensation after implant placement in the posterior segment of the mandible when a panoramic radiograph is the only preoperative imaging technique used. MATERIAL AND METHODS: The study included 1527 partially and totally edentulous patients who had consecutively received 2584 implants in the posterior segment of the mandible. Preoperative bone height was evaluated from the top of the alveolar crest to the superior border of the mandibular canal on a standard panoramic radiograph. A graduated implant scale from the implant manufacturer was used and 2 mm were subtracted as a safety margin to determine the length of the implant to be inserted. RESULTS: No permanent sensory disturbances of the inferior alveolar nerve were observed. There were two cases of postoperative paresthesia, representing 2/2584 (0.08%) of implants inserted in the posterior segment of the mandible or 2/1527 (0.13%) of patients. These sensory disturbances were minor, lasted for 3 and 6 weeks and resolved spontaneously. CONCLUSIONS: Panoramic examination can be considered a safe preoperative evaluation procedure for routine posterior mandibular implant placement. Panoramic radiography is a quick, simple, low-cost and low-dose presurgical diagnostic tool. When a safety margin of at least 2 mm above the mandibular canal is respected, panoramic radiography appears to be sufficient to evaluate available bone height prior to insertion of posterior mandibular implants; cross-sectional imaging techniques may not be necessary.

Objective The aim of the present pilot study was to evaluate: (1) the predictability of an osteotome sinus floor elevation procedure with ITI-SLA implants without placing a bone grafting material, and (2) the possibility to gain bone height without filling the created space with a bone grafting material. Material and methods Seventeen patients received 25 implants protruding in the sinus. Most implants (21/25) were 10 mm long, eight were inserted in type 2 bone, 12 in type 3 and five in type 4 bone. At implant placement, the mean residual bone height (RBH) under the maxillary sinus was 5.4+/-2.3 mm; it was 5.7+/-2.6 mm on the mesial side and 5.1+/-1.9 mm on the distal side. Nineteen implants had less than 6 mm of bone on at least one side and six implants had less than 6 mm on both sides. A healing period of 3-4 months was allowed before abutment tightening at 35 Ncm. The percentage of stable implants at abutment tightening and at the 1-year control was calculated. The endo-sinus bone gain and the crestal bone loss (CBL) at the mesial and distal sides were measured. Results Abutments were tightened after 3.1+/-0.4 months. All implants but one (96%) resisted the applied 35 Ncm torque. At the 1-year control, all implants were clinically stable and supported the definitive prosthesis. All showed endo-sinus bone gain; the mean gain was 2.5+/-1.2 mm. The mean CBL was 1.2+/-0.7 mm. Endo-sinus bone gain and RBH showed a strong negative correlation (r=-0.78 on the mesial side and -0.80 on the distal side). A good correlation (r=0.73) was found between implant penetration in the sinus and endo-sinus bone gain. Conclusion Elevation of the sinus membrane alone without addition of bone grafting material can lead to bone formation beyond the original limits of the sinus floor. Despite a limited RBH at implant placement, a healing period of 3 months was sufficient to resist a torque of 35 N cm and to lead to a predictable implant function at the 1-year control.

The aim of this project was to evaluate the potential of bone formation by the distraction of periosteum. Distraction of calvarial bone in 12 rabbits at 0.25 mm a day caused formation of bone in 3 animals, and distraction at 0.5 mm a day caused formation of bone in 2. A second trial of alveolar distraction in four dogs using a specifically-designed distraction device showed lack of stability of the device.

A 95-year-old white woman, hospitalized for a pseudomonas bacteremia, was referred to the Department of Oral Surgery Oral Medicine and Oral and Maxillofacial Radiology, School of Dental Medicine, University of Geneva, for pain and bone exposure in the left mandibular region. Intraoral examination revealed massive deposits of calculus on the lingual surface of the posterior teeth with a large area of gingival recession of the mandibular second molar. The panoramic radiograph (Fig 1) showed an irregular intraosseous radiopaque mass surrounded by a well delineated radiolucent image attached to the roots of the left mandibular second molar. The radiolucency also involved the first molar, which presented partial root resorption. Both molars were extracted. A mass measuring approximately 1.5 cm in diameter was firmly fixed to the apex of the secondmolar. All inflammatory tissue adjacent to themasswas curetted. Microscopic examination of the material attached to the apex showed multiple friable calcified irregular fragments identified as calculus. It contained filamentous bacteria in some places and colonies of cocci in others. Numerous neutrophils were present at the periphery of some of the calcified fragments. Supragingival and subgingival masses of calculus deposits have frequently been reported. To the best of our knowledge this is the second reported case of periapical deposits.

The anchorage of machined Brånemark and ITI TPS-coated implants of various lengths was investigated in an animal model. Brånemark fixtures 7 and 10 mm long and ITI implants 6 and 10 mm long were inserted in the mandible of dogs and were reverse-torqued after 3 months of healing. The failing mode was different for the two implant systems. For the ITI implants, loosening coincided with the peak reverse-torque values. For the Brånemark fixtures, two reverse-torque values were identified and recorded, a 'start to rotate' and a peak value. The 'start to rotate' values for the 7 and 10 mm Brånemark fixtures were 36.67 and 38.57 Ncm, respectively, the peak values were 61.88 and 69.13 Ncm. The increase in implant length from 7 to 10 mm did not significantly improve the anchorage. The mean reverse-torque values for the 6- and 10-mm ITI implants were 104.66 and 192.25 Ncm, respectively; the difference was statistically significant. The mean removal torque of the 6-mm ITI implant was higher than the 7- and 10-mm Brånemark implants. It is suggested that the distinct anchorage magnitude and the distinct loosening patterns registered for both implant systems might be related to the various surface states. The latter might account for the different failure tendencies mentioned in the literature for short Brånemark and ITI implants.

L'artere labiale de calibre persistant semble etre relativement frequente mais rarement decrite, la plupart des cas seraient asymptomatiques. L'echo-Doppler couleur permet de confirmer le diagnostic sans avoir recours a un acte invasif

Conventional panoramic radiography, a widely used radiographic examination tool in implant treatment planning, allows evaluation of the available bone height before inserting posterior mandibular implants. Image distortion and vertical magnification due to projection geometry is well described for rotational panoramic radiographs. To assess the accuracy of vertical height measurements on direct digital panoramic radiographs, implants and metal balls positioned in the posterior mandible were used as radio-opaque reference objects. The reproducibility of the measuring method was assessed by the inter- and intraobserver agreements.Direct digital panoramic radiographs, performed using a Kodak 8000C (Eastman Kodak Company, Rochester, NY), of 17 partially edentulous patients (10 females, 7 males, mean age 65 years) were selected from an X-ray database gathered during routine clinical evaluation of implant sites. Proprietary software and a mouse-driven calliper were used to measure the radiological length of 25 implants and 18 metal reference balls, positioned in mandibular posterior segments. The distortion ratio (DR) was calculated by dividing the radiological implant length by the implant's real length and the radiological ball height by the ball's real height.Mean vertical DR was 0.99 for implants and 0.97 for balls, and was unrelated to mandibular sites, side, age, gender or observer. Inter- and intraobserver agreements were acceptable for both reference objects.Vertical measurements had acceptable accuracy and reproducibility when a software-based calibrated measurement tool was used, confirming that digital panoramic radiography can be reliably utilized to determine the pre-operative implant length in premolar and molar mandibular segments.

Si le baroque affermissait les consciences en contrastant les beautes du present et la mort a venir, le rococo actualise les signes de la violence et du trepas dans la plenitude meme de la vie. C’est de cet imaginaire rococo, bizarre, etrange, ambigu, issu des fantasmes de l’enfance, âge insouciant dont les reves sont peuples de monstres, que Goya tire un panorama bifrons unique. On tentera de classer ces images dans leur bizarre et inquietante reversibilite.

Isabel Herrero & Lydia Vasquez : European national types in French fiction (1750-1789). In French fiction the European but also different national types are clearly shown through the characters portrayed. In travel fiction, a Frenchman voyaging through Europe meets different national types : the pale, cold, mercenary and irreverent Englishman ; the handsome but over-passionate, superstitious and insincere italian ; the lively but proud and lazy Spaniard. There is a negative vision of other nations whose descriptions are dictated more by a desire to reassert French nationality than to learn, for the particular descriptions conceal a Gallocentrism embodied in the travelling hero. He is objective, sensitive, delicate, polite, friendly and sociable., Herrero Isabel, Vazquez Lydia. Types nationaux européens dans des œuvres de fiction françaises (1750-1789). In: Dix-huitième Siècle, n°25, 1993. L'Europe des Lumières. pp. 115-127.