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Du corps reconstitué au corps reconfiguré : pour une compréhension éthique de l'appareillage prothétique à l'ère du techno-enchantement / From reconstituted body to reconfigured body : an ethical understanding of prosthetic devices, in a techno-enchantment eraGourinat, Valentine 14 December 2018 (has links)
Ce travail de thèse porte sur les représentations sociales du corps amputé et appareillé, dans l’imaginaire collectif contemporain. Il s’agira d’observer, de comparer et d’analyser la façon dont l’espace public et médiatique s’empare du champ des prothèses, et de confronter ces projections et imaginaires collectifs, avec la façon dont les amputés eux mêmes (mais aussi les soignants qui côtoient et les entourent) se représentent et construisent leur identité sociale et corporelle, afin de démontrer qu'un certain décalage sépare ce que l'on croit connaître des amputés et des prothèses, et ce qu'il en est réellement sur le terrain (problématiques réelles, pratiques et usages au quotidien). L’objectif sera aussi de tenter de formuler des propositions permettant de remettre la personne amputée au coeur de considérations plus rationnelles, pragmatiques et éthiques, loin de toute projection, spéculation et fantasmagorie. / This thesis research focuses on the social representations of the amputated body fitted with prostheses, in the light of the contemporary collective imagination. The aim will be to observe, compare and analyse the way in which the public and media consider the field of prostheses, and bring these collective projections and imaginations face to face with how the amputees (but also the care givers who surround them) see themselves and construct their own social and bodily identity. The goal is to reveal the existence of a certain gap between what the collective discourse producers (media, scientists) think to know about amputees and prostheses, and the reality observed on site (practical problems, customs and practices of everyday life). The final aim will be to formulate proposals to overcome these ambiguous conceptions, to question the notions of social inclusion and exclusion of disability and the technological repairs of the body, and to put the amputees at the heart of more rational, pragmatic and ethical considerations, far from any prediction, speculation and phantasmagoria.
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Estimation of Turbulence using Magnetic Resonance ImagingDyverfeldt, Petter January 2005 (has links)
<p>In the human body, turbulent flow is associated with many complications. Turbulence typically occurs downstream from stenoses and heart valve prostheses and at branch points of arteries. A proper way to study turbulence may enhance the understanding of the effects of stenoses and improve the functional assessment of damaged heart valves and heart valve prostheses.</p><p>The methods of today for studying turbulence in the human body lack in either precision or speed. This thesis exploits a magnetic resonance imaging (MRI) phenomenon referred to as signal loss in order to develop a method for estimating turbulence intensity in blood flow.</p><p>MRI measurements were carried out on an appropriate flow phantom. The turbulence intensity results obtained by means of the proposed method were compared with previously known turbulence intensity results. The comparison indicates that the proposed method has great potential for estimation of turbulence intensity.</p>
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Estimation of Turbulence using Magnetic Resonance ImagingDyverfeldt, Petter January 2005 (has links)
In the human body, turbulent flow is associated with many complications. Turbulence typically occurs downstream from stenoses and heart valve prostheses and at branch points of arteries. A proper way to study turbulence may enhance the understanding of the effects of stenoses and improve the functional assessment of damaged heart valves and heart valve prostheses. The methods of today for studying turbulence in the human body lack in either precision or speed. This thesis exploits a magnetic resonance imaging (MRI) phenomenon referred to as signal loss in order to develop a method for estimating turbulence intensity in blood flow. MRI measurements were carried out on an appropriate flow phantom. The turbulence intensity results obtained by means of the proposed method were compared with previously known turbulence intensity results. The comparison indicates that the proposed method has great potential for estimation of turbulence intensity.
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Mekaniska och kemiska egenskaper hos PEEK och PEKK inom tandvården : En systematisk översikt / Mechanical and chemical properties of PEEK and PEKK in dentistry : A systematic reviewÖjvindsson Hörgård, Cecilia, Aso, Vanja January 2023 (has links)
Syfte Syftet med föreliggande studie är att genom en systematisk översikt identifiera skillnaderna i de kemiska och mekaniska egenskaperna hos materialen PEEK och PEKK och till vilka dentala applikationer materialen kan användas. Material och metod Materialens kemiska och mekaniska egenskaper identifierades genom litteratursökning med PRISMA och PICO-systemet. Databaserna som användes var PubMed, Scopus samt Web of Science. Granskning gjordes på titel-, abstrakt- och fulltextnivå, baserat på inklusions- och exklusionskriterier. Resultat Sökningen resulterade i totalt 226 artiklar varav 210 artiklar i PubMed, nio artiklar i Scopus och sju artiklar i Web of Science. Efter kontroll av dubbletter och bedömning utifrån inklusions- och exklusionskriterier var det totalt sju artiklar som analyserades på fulltextnivå. Av dessa sju artiklarna utvärderades olika materialegenskaper där de använda materialtesterna skiljde sig åt. I fem artiklar utvärderades bindningsstyrkan mellan fasadmaterial och PEEK och/eller PEKK. En artikel undersökte ytan hos materialen beroende på ytbehandling och en artikel testade tryckhållfasthet på tre-ledsbroar av PEEK och PEKK. Båda materialen uppvisade liknande mekaniska och kemiska egenskaper vid jämförelse mot varandra. Slutsats PEEK och PEKKs mekaniska och kemiska egenskaper skiljer sig inte åt. Mer forskning och kliniska data behövs om materialens dentala applikationer. Nyckelord: Avtagbar protetik, fast protetik, högpresterande polymer, PAEK, tandvård / Purpose The purpose of the present study is to carry out a systematic review to identify the differences in mechanical and chemical properties of the materials PEEK and PEKK, as well as which dental applications the materials can be used for. Material and method The materials’ mechanical and chemical properties were identified using PRISMA and PICO system through a literature search. The databases used were PubMed, Scopus and Web of Science. Screening and assessing were done at title, abstract and full text level, based on the inclusion and exclusion criteria. Results The search resulted in a total of 226 articles, whereon 210 articles in PubMed, nine articles in Scopus and seven articles in Web of Science. After removal of duplicates and assessment of the studies according to the inclusion and exclusion criteria, the total amount of studies reviewed was seven. In these seven articles, different properties were evaluated, and the tests used differed. In five articles, the shear bond strength between veneering materials and PEEK and/or PEKK was tested. In one article the surface roughness depending on surface treatment was tested and in another, the strength of three-unit fixed dental prostheses made of PEEK and PEKK was tested. PEEK and PEKK showed similar mechanical and chemical properties in comparison to each other. Conclusion The mechanical and chemical properties of PEEK and PEKK do not differ. More research and clinical data are needed on the dental applications of the materials.Keywords: Dentistry, fixed dental prosthesis, high-performance polymer, removable dental prothesis, PAEK.
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The clinical success, survival and failure of titanium-ceramic tooth-supported constructions submitted to patients at the Faculty of Odontology, Malmö University - A retrospective clinical studyBlom, Åsa, Mahlberg, Marie January 2017 (has links)
Syfte:Syftet med föreliggande studie var att utvärdera kliniskt lyckande, överlevnad och misslyckande för metal-keramiska singelkronor och broar med underkonstruktion av titan som lämnats ut till patienter på Odontologiska fakulteten, Malmö högskola. Material och metod:För att svara på den aktuella frågeställningen identifierades patienter som mellan åren 2011-2015 fått fastsittande protetiska konstruktioner i titan-keramik, på Odontologiska fakulteten, Malmö högskola. Patienterna undersöktes av två tandläkarstudenter, under deras åttonde termin (april 2016), med visuell-taktil metod. Resultat:47 stycken patienter ingick i studien, detta motsvarade 69% av alla patienter som matchade inklusions - och exklusionskriterierna. Hos dessa 47 patienter fanns totalt 67 konstruktioner med en medelålder på 35 månader och en medianålder på 29 månader. Av de inkluderade konstruktionerna var 47 stycken singelkronor och 20 broar. Den kliniska lyckande, överlevnad och misslyckande frekvensen för singelkronorna var 55%, 43% och 2%, medan den för broarna var 15%, 70% och 15%. Slutsats:Inom studiens begränsningar har följande slutsatser dragits: •De titan-keramiska singelkronorna utlämnade till patienter på Odontologiska fakulteten, Malmö högskola, hade en högre lyckandefrekvens än de titan-keramiska broarna.•Resultatet indikerade en övergripande hög lyckande- och överlevnadsfrekvens för titan-keramiska konstruktioner. / Aim:The aim of this study was to evaluate the clinical success, survival and failure rate of titanium-ceramic single crowns (SCs) and fixed dental prostheses (FDPs) submitted to patients at the Faculty of Odontology, Malmö University. Materials and Method:To answer the research question, patients with SCs and/or FDPs made in titanium-ceramic at the Faculty of Odontology, Malmö University, between year 2011-2015, were identified and later examined by, two dental students during their eight semester (April 2016), with a visual-tactile method. Results:The study contained a total of 47 participating patients, this outcome represented 69 % of all the patients found matching the inclusion and exclusion criteria during the patient selection. Out of the 47 participants, 67 restorations were obtained and examined. The 67 restorations that were included in the study had a mean age of 35 months and a median age of 29 months. Out of these, 47 were SCs and 20 were FDPs. The clinical success, survival and failure rate of the SCs were 55%, 43% and 2%, respectively. The clinical success, survival and failure rate of the FDPs were 15%, 70% and 15%, respectively. Conclusion:Within limits of this study the following conclusions were made:•The titan-ceramic SCs submitted to patients at the Faculty of Odontology, Malmö University had a higher success rate compared to the FDPs.•The results indicate an overall high and acceptable success and survival rate for the titan-ceramic restorations.
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Stomatite prothétique, candidose orale et leur évolution dans le tempsSavignac, Katia 07 1900 (has links)
Objectifs: Observer l’évolution de la stomatite prothétique dans le temps quant à la fréquence et la sévérité ainsi que son association avec de potentiels facteurs de risque au cours d’un suivi longitudinal de 2 ans.
Matériels et méthodes : Cent trente-cinq patients âgés complètement édentés et en bonne santé ont été sélectionnés pour participer à cette étude et ont été divisés de façon randomisée en deux groupes. Ils ont tous reçu une prothèse dentaire amovible totale conventionnelle au maxillaire supérieur. La moitié d’entre eux a reçu une prothèse totale mandibulaire implanto-portée retenue par deux attachements boule et l’autre moitié une prothèse conventionnelle. Ils ont été suivis sur une période de deux ans. Les données sociodémographiques, d’habitudes de vie, d’hygiène et de satisfaction des prothèses ont été amassées à l’aide de questionnaires. Les patients ont aussi subi un examen oral complet lors duquel une évaluation de la stomatite prothétique, basée sur la classification de Newton, a été effectuée ainsi qu’un prélèvement de la plaque prothétique. Les analyses microbiologiques pertinentes afin de détecter la présence de Candida ont ensuite été effectuées. Des tests Chi-carré de Pearson et McNemar ont été utilisés pour analyser la fréquence de la stomatite, son association avec de possibles facteurs de risque ainsi que son évolution dans le temps. Des rapports de cotes (odds ratio) et leurs intervalles de confiance (95%) ont été effectués afin de déterminer la force d’association entre les facteurs de risque et la stomatite prothétique.
Résultats : La prévalence de la stomatite a augmenté entre la première (63,6%) et la deuxième année de suivi (88,7%) avec une incidence de 78,8%. Les patients souffrant d’une stomatite de type 2 ou 3 et qui brossent leur palais ont environ 6 fois plus de chance de voir la sévérité de leur stomatite diminuer [p = 0,04 OR 5,88 CI (1,1-32,2)]. Il n’y a pas d’association statistiquement significative entre la fréquence de la stomatite et les facteurs de risque investigués. La prévalence de la candidose est demeurée stable dans le temps (45,8% et 49,2% à la première et deuxième année de suivi respectivement, p > 0,05). Il n’y a pas d’association entre la présence d’une candidose orale, la stomatite prothétique et les facteurs de risque étudiés.
Conclusion : Les résultats de cette étude suggèrent que la stomatite prothétique progresse dans le temps indépendamment de la présence d’une candidose. Le brossage du palais pourrait être une approche simple à conseiller aux patients souffrant d’une stomatite prothétique de type 2 ou 3. / Objectives: To assess the evolution of denture stomatitis in term of frequency and severity and its association with potential risk factors over a two-year period.
Methods: One hundred thirty five healthy edentulous elders who were randomly rehabilitated with a maxillary complete denture opposed by a conventional denture or an implant-supported overdenture retained by two ball attachments were followed over two years. Demographic and clinical data concerning oral and general health, smoking, denture status and hygienic habits were obtained from oral examination and standard questionnaires. Denture stomatitis was evaluated according to Newton’s classification. Microbiological analyses consist of detection of Candida species in denture plaque and inoculation in selective growth medium. Pearson Chi-square and McNemar tests were used to analyse the frequency of denture stomatitis, its association with potential risk factors and it’s evolution over time. Odds ratios and their 95% confidence intervals were calculated to determine the strength of association between risk factors and denture stomatitis.
Results: The prevalence of denture stomatitis increased between the first (63.6%) and second year follow-up (88.7%) with an incidence rate of 78.8%. Those individuals suffering from type 2 or type 3 denture stomatitis and who brushed their palate had approximately 6 times more chance of observing a decrease in the severity of their condition [p=0.04 OR 5.88 CI (1.1-32.2)]. There was no statistically significant association between the frequency of denture stomatitis and classical risk factors at both follow-ups. The carriage rate of Candida species remained stable over time (45.8% and 49.2% first and second year of follow-up consecutively, p > 0.05). There was no association between the presence of oral candidiosis and denture stomatitis or its potential risk factors.
Conclusion: The results of this study suggest that denture stomatitis progresses overtime independent of Candida carriage. Palatal brushing could be a preventive approach to minimise the inflammation in individuals suffering from type 2 or type 3 denture stomatitis.
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Fatores preditivos do insucesso clínico no tratamento das fístulas esofagorrespiratórias com prótese metálica autoexpansível em pacientes com câncer esofágico / Predictive factors of clinical failure of treatment of malignant esophageal fistula with self-expandable metallic stentsRibeiro, Maria Sylvia Ierardi 11 September 2017 (has links)
INTRODUÇÃO: A fistula esofagorrespiratória é complicação temida do câncer esofágico avançado. A paliação com prótese metálica autoexpansível é método amplamente empregado, porém com resultados conflitantes. OBJETIVO: Identificar fatores associados ao insucesso clínico do tratamento da fístula esofagorrespiratória maligna com prótese metálica autoexpansível. MÉTODOS: Estudo retrospectivo através da análise de banco de dados elaborado de forma prospectiva de pacientes submetidos ao tratamento da fístula esofagorrespiratória maligna com prótese metálica autoexpansível entre janeiro de 2009 e fevereiro de 2016 em hospital terciário dedicado ao tratamento do câncer. Foram coletados dados quanto à: características demográficas, nível de albumina sérica, capacidade funcional do paciente, doença pulmonar infecciosa em atividade no momento da passagem da prótese, tratamentos oncológicos prévios, momento do diagnóstico da fístula, tamanho e localização do trajeto fistuloso. RESULTADOS: Um total de 71 pacientes foram incluídos no estudo (55 homens, idade média de 59 anos). Insucesso clínico ocorreu em 44.3% dos pacientes. ECOG 3 ou 4, desenvolvimento da fístula durante o tratamento do câncer esofágico e diâmetro da fístula >= 1 cm foram fatores preditivos do insucesso clínico. ECOG 3 ou 4, doença pulmonar infecciosa em atividade no momento da passagem da prótese e tratamento oncológico prévio com radioterapia foram fatores preditivos de menor sobrevida. O grau de disfagia melhorou significativamente 15 dias após a passagem da prótese. A taxa total de eventos adversos foi de 30%. Migração da prótese e a oclusão da mesma por crescimento tumoral nas extremidades da prótese foram os eventos adversos mais comumente observados. CONCLUSÃO: A prótese metálica autoexpansível é um método terapêutico efetivo para o tratamento da fístula esofagorrespiratória maligna, no entanto, ECOG 3 ou 4, desenvolvimento da fístula durante o tratamento do câncer esofágico e diâmetro da fístula >= 1cm foram fatores preditivos do insucesso clínico após a passagem da prótese / INTRODUCTION: Malignant esophagorespiratory fistula is a serious and life-threatening complication of esophageal cancer. Self-expandable metal stents placement is a well accepted palliative treatment, however, with conflicting results. OBJECTIVE: To identify risk factors associated with clinical failure after self-expandable metal stents placement for the treatment of malignant esophagorespiratory fistula. METHODS: This was a retrospective analysis of a prospectively maintained database used at a tertiary cancer hospital, with patients treated with SEMS placement for MERF between January 2009 and February 2016. The following variables were collected: patient demographics, serum albumin level, Eastern Cooperative Oncology Group (ECOG) performance status, pulmonary infection, previous oncologic treatment, moment of diagnosis of the malignant esophagorespiratory fistula, size and classification of the fistulous tract. RESULTS: A total of 71 patients (55 males, mean age 59 years) were considered for the final analysis. Clinical failure occurred in 44.3% of the patients. ECOG 3 or 4, fistula development during esophageal cancer treatment and fistula diameter >= 1cm were factors associated with increased risk of clinical failure. ECOG 3 or 4, pulmonary infection at the time of SEMS placement and prior radiation therapy were predictive factors associated with lower overall survival. Dysphagia scores improved significantly 15 days after stent insertion. The overall stent-related adverse events rate was 30%. Stent migration and occlusion due to tumor overgrowth were the most commonly seen adverse events. CONCLUSION: SEMS placement is a reasonable treatment option for MERF, however, ECOG 3 or 4, fistula development during esophageal cancer treatment or large fistula diameter may be independent predictors of clinical failure after stenting
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Fatores preditivos do insucesso clínico no tratamento das fístulas esofagorrespiratórias com prótese metálica autoexpansível em pacientes com câncer esofágico / Predictive factors of clinical failure of treatment of malignant esophageal fistula with self-expandable metallic stentsMaria Sylvia Ierardi Ribeiro 11 September 2017 (has links)
INTRODUÇÃO: A fistula esofagorrespiratória é complicação temida do câncer esofágico avançado. A paliação com prótese metálica autoexpansível é método amplamente empregado, porém com resultados conflitantes. OBJETIVO: Identificar fatores associados ao insucesso clínico do tratamento da fístula esofagorrespiratória maligna com prótese metálica autoexpansível. MÉTODOS: Estudo retrospectivo através da análise de banco de dados elaborado de forma prospectiva de pacientes submetidos ao tratamento da fístula esofagorrespiratória maligna com prótese metálica autoexpansível entre janeiro de 2009 e fevereiro de 2016 em hospital terciário dedicado ao tratamento do câncer. Foram coletados dados quanto à: características demográficas, nível de albumina sérica, capacidade funcional do paciente, doença pulmonar infecciosa em atividade no momento da passagem da prótese, tratamentos oncológicos prévios, momento do diagnóstico da fístula, tamanho e localização do trajeto fistuloso. RESULTADOS: Um total de 71 pacientes foram incluídos no estudo (55 homens, idade média de 59 anos). Insucesso clínico ocorreu em 44.3% dos pacientes. ECOG 3 ou 4, desenvolvimento da fístula durante o tratamento do câncer esofágico e diâmetro da fístula >= 1 cm foram fatores preditivos do insucesso clínico. ECOG 3 ou 4, doença pulmonar infecciosa em atividade no momento da passagem da prótese e tratamento oncológico prévio com radioterapia foram fatores preditivos de menor sobrevida. O grau de disfagia melhorou significativamente 15 dias após a passagem da prótese. A taxa total de eventos adversos foi de 30%. Migração da prótese e a oclusão da mesma por crescimento tumoral nas extremidades da prótese foram os eventos adversos mais comumente observados. CONCLUSÃO: A prótese metálica autoexpansível é um método terapêutico efetivo para o tratamento da fístula esofagorrespiratória maligna, no entanto, ECOG 3 ou 4, desenvolvimento da fístula durante o tratamento do câncer esofágico e diâmetro da fístula >= 1cm foram fatores preditivos do insucesso clínico após a passagem da prótese / INTRODUCTION: Malignant esophagorespiratory fistula is a serious and life-threatening complication of esophageal cancer. Self-expandable metal stents placement is a well accepted palliative treatment, however, with conflicting results. OBJECTIVE: To identify risk factors associated with clinical failure after self-expandable metal stents placement for the treatment of malignant esophagorespiratory fistula. METHODS: This was a retrospective analysis of a prospectively maintained database used at a tertiary cancer hospital, with patients treated with SEMS placement for MERF between January 2009 and February 2016. The following variables were collected: patient demographics, serum albumin level, Eastern Cooperative Oncology Group (ECOG) performance status, pulmonary infection, previous oncologic treatment, moment of diagnosis of the malignant esophagorespiratory fistula, size and classification of the fistulous tract. RESULTS: A total of 71 patients (55 males, mean age 59 years) were considered for the final analysis. Clinical failure occurred in 44.3% of the patients. ECOG 3 or 4, fistula development during esophageal cancer treatment and fistula diameter >= 1cm were factors associated with increased risk of clinical failure. ECOG 3 or 4, pulmonary infection at the time of SEMS placement and prior radiation therapy were predictive factors associated with lower overall survival. Dysphagia scores improved significantly 15 days after stent insertion. The overall stent-related adverse events rate was 30%. Stent migration and occlusion due to tumor overgrowth were the most commonly seen adverse events. CONCLUSION: SEMS placement is a reasonable treatment option for MERF, however, ECOG 3 or 4, fistula development during esophageal cancer treatment or large fistula diameter may be independent predictors of clinical failure after stenting
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Développement de nouveaux matériaux céramiques à base de zircone pour application dentaire / Development of new zirconia based ceramics for dental applicationCourtois, Nicolas 06 December 2011 (has links)
Les céramiques polycristallines pour application dentaire sont aujourd’hui majoritairement des zircones dopées à l’yttrium (Y-TZP). Ce matériau présente des avantages indéniables en terme de résistance à la rupture, de propriétés esthétiques ou encore de ténacité grâce au phénomène de renforcement par transformation de phase. Les problèmes de stabilité de la Y-TZP en présence d’eau peuvent être limités par un travail d’optimisation des poudres, mais la sensibilité intrinsèque du matériau vis-à-vis de l’eau ou des fluides biologiques demeure et représente un risque, spécialement dans le cadre d’applications cliniques. Les matériaux à base de zircone dopée au cérium (Ce-TZP) présentés dans cette étude ont été développés afin de répondre au triple objectif de ténacité, résistance et stabilité. A partir de la Ce-TZP, connue pour sa ténacité et sa stabilité en présence d’eau importantes, un travail d’optimisation de la microstructure a été réalisé afin d’obtenir une résistance à la rupture maximale. Différentes voies ont été explorées afin d’élaborer des microstructures permettant une augmentation de la résistance mécanique de la Ce-TZP, notamment le frittage SPS ou l'élaboration de composites par mélange de poudres commerciales. Parmi les résultats présentés, le plus marquant est sans doute l’élaboration de composites dans le système 10Ce-TZP/MgAl2O4, caractérisés par une combinaison de propriétés mécaniques inédite (Sigma R = 900 MPa, KIc >15MPa.m1/2), et une stabilité à très long terme en présence d’eau . La mise en forme de ce matériau par des procédés industriels de pressage a été rendue possible grâce à une étape de granulation par atomisation ultrasonique. Enfin, un axe de recherche a été dédié à l’élaboration de poudres composites à base de Ce-TZP en une seule étape, par synthèse chimique. Ces travaux plus prospectifs montrent qu’un mélange très intime de deux phases peut-être obtenu par des méthodes de chimie douce dans une poudre composite. Ces poudres permettent l’élaboration de matériaux nanostructurés, dont les propriétés pourraient dépasser celles des composites conventionnels. / Yttria-doped tetragonal zirconia ceramics (often referred as Y-TZP) are today of major interest in biomedical and particularly dental applications, due to their excellent combination of strength and aesthetic features. Nevertheless, the moderate toughness of 3Y-TZP, and its still possible low temperature degradation (LTD) leaves space for new materials development. The purpose of this study is to assess the potential benefit of using ceria-doped zirconia (Ce-TZP) based ceramics as an tough, strong and stable alternative to Y-TZP. Ce-TZP generally possesses high toughness, but moderate strength when compared to 3Y-TZP, which is related to a larger grain size. In order to improve the strength of Ce-TZP, three microstructural optimizations have been carried out. First, Spark Plasma Sintering (SPS) has been used, showing a good potential for the development of nanostructured materials, which can be dense and mainly tetragonal, but aesthetically incompatible with a dental application. Cerium reduction effects on color and phase repartition have been studied. Adding a second step of conventional sintering in air has led to fully dense submicron 12Ce-TZP with acceptable color, but unsufficient strengthening. In a second step, a conventional composite approach has been used, by mixing commercial powders. The most striking result is certainly the uncommon combination of mechanical properties (Sigma R = 900 MPa, KIc > 15MPa.m1/2) obtained in the system 10Ce-TZP/MgAl2O4, together with a long term stability in presence of water. Pilot scale processing of this material has been set up by mean of ultrasonic spray-drying. Finally, a third research axis has been devoted to the synthesis of composite powders based on Ce-TZP, in one step. This work has shown that a very close mix of two phases can be obtained par soft chemistry methods in a composite powder. Nanostructured materials can be obtained from these powders, which properties could exceed those of conventional composites.
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Stomatite prothétique, candidose orale et leur évolution dans le tempsSavignac, Katia 07 1900 (has links)
Objectifs: Observer l’évolution de la stomatite prothétique dans le temps quant à la fréquence et la sévérité ainsi que son association avec de potentiels facteurs de risque au cours d’un suivi longitudinal de 2 ans.
Matériels et méthodes : Cent trente-cinq patients âgés complètement édentés et en bonne santé ont été sélectionnés pour participer à cette étude et ont été divisés de façon randomisée en deux groupes. Ils ont tous reçu une prothèse dentaire amovible totale conventionnelle au maxillaire supérieur. La moitié d’entre eux a reçu une prothèse totale mandibulaire implanto-portée retenue par deux attachements boule et l’autre moitié une prothèse conventionnelle. Ils ont été suivis sur une période de deux ans. Les données sociodémographiques, d’habitudes de vie, d’hygiène et de satisfaction des prothèses ont été amassées à l’aide de questionnaires. Les patients ont aussi subi un examen oral complet lors duquel une évaluation de la stomatite prothétique, basée sur la classification de Newton, a été effectuée ainsi qu’un prélèvement de la plaque prothétique. Les analyses microbiologiques pertinentes afin de détecter la présence de Candida ont ensuite été effectuées. Des tests Chi-carré de Pearson et McNemar ont été utilisés pour analyser la fréquence de la stomatite, son association avec de possibles facteurs de risque ainsi que son évolution dans le temps. Des rapports de cotes (odds ratio) et leurs intervalles de confiance (95%) ont été effectués afin de déterminer la force d’association entre les facteurs de risque et la stomatite prothétique.
Résultats : La prévalence de la stomatite a augmenté entre la première (63,6%) et la deuxième année de suivi (88,7%) avec une incidence de 78,8%. Les patients souffrant d’une stomatite de type 2 ou 3 et qui brossent leur palais ont environ 6 fois plus de chance de voir la sévérité de leur stomatite diminuer [p = 0,04 OR 5,88 CI (1,1-32,2)]. Il n’y a pas d’association statistiquement significative entre la fréquence de la stomatite et les facteurs de risque investigués. La prévalence de la candidose est demeurée stable dans le temps (45,8% et 49,2% à la première et deuxième année de suivi respectivement, p > 0,05). Il n’y a pas d’association entre la présence d’une candidose orale, la stomatite prothétique et les facteurs de risque étudiés.
Conclusion : Les résultats de cette étude suggèrent que la stomatite prothétique progresse dans le temps indépendamment de la présence d’une candidose. Le brossage du palais pourrait être une approche simple à conseiller aux patients souffrant d’une stomatite prothétique de type 2 ou 3. / Objectives: To assess the evolution of denture stomatitis in term of frequency and severity and its association with potential risk factors over a two-year period.
Methods: One hundred thirty five healthy edentulous elders who were randomly rehabilitated with a maxillary complete denture opposed by a conventional denture or an implant-supported overdenture retained by two ball attachments were followed over two years. Demographic and clinical data concerning oral and general health, smoking, denture status and hygienic habits were obtained from oral examination and standard questionnaires. Denture stomatitis was evaluated according to Newton’s classification. Microbiological analyses consist of detection of Candida species in denture plaque and inoculation in selective growth medium. Pearson Chi-square and McNemar tests were used to analyse the frequency of denture stomatitis, its association with potential risk factors and it’s evolution over time. Odds ratios and their 95% confidence intervals were calculated to determine the strength of association between risk factors and denture stomatitis.
Results: The prevalence of denture stomatitis increased between the first (63.6%) and second year follow-up (88.7%) with an incidence rate of 78.8%. Those individuals suffering from type 2 or type 3 denture stomatitis and who brushed their palate had approximately 6 times more chance of observing a decrease in the severity of their condition [p=0.04 OR 5.88 CI (1.1-32.2)]. There was no statistically significant association between the frequency of denture stomatitis and classical risk factors at both follow-ups. The carriage rate of Candida species remained stable over time (45.8% and 49.2% first and second year of follow-up consecutively, p > 0.05). There was no association between the presence of oral candidiosis and denture stomatitis or its potential risk factors.
Conclusion: The results of this study suggest that denture stomatitis progresses overtime independent of Candida carriage. Palatal brushing could be a preventive approach to minimise the inflammation in individuals suffering from type 2 or type 3 denture stomatitis.
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