Introduction: Sialolithiasis is defined by the presence of a calculus within the salivary gland or its excretory system. It primarily affects the submandibular gland at a frequency of 80%. Involving many factors, the exact aetiology and pathogenesis of salivary calculi remain to be discussed. Body: The purpose of this article is to expose the different aspects of the pathology. Aetiological factors, the diagnostic approach which requires the use of imaging tests as well as the medical and surgical management of anterior submandibular sialolithiasis, will be described. A decision tree regarding the type of management and a table summarizing the main differential diagnoses will be proposed. Conclusion: Submandibular sialolithiases are a common salivary gland disorder. The treatment of sialolithiasis must be early and remains mainly surgical. The level of cooperation as well as the patient's medical and surgical history should guide the management of this type of disorder of the salivary system.
The effect of probiotics in improving or maintaining oral health in orthodontic patients is understudied. The aim of this study is to evaluate the effect of probiotic administration in addition to tooth brushing on clinical gingival inflammation, plaque formation, subgingival microbiota composition, and salivary biomarkers of inflammation in adolescents with fixed orthodontic appliances. The present study is a 6-month, double-blind, two-arm, placebo-controlled, single-center trial, in which 116 adolescent volunteers aged 12–16 years will be recruited from the patients of the orthodontics clinic of the University Hospital of Lille, France. Subjects who meet the eligibility criteria will be allocated to one of the following groups: (i) control: two placebo lozenges per day for 90 days together with regular oral hygiene, (ii) test: two probiotic lozenges per day for 90 days together with regular oral hygiene. Clinical assessment and biological sample collection will be performed at baseline, 3 and 6 months. In addition, compliance outcomes and adverse events will be monitored.
RÉSUMÉLes progrès du traitement des cancers de l'enfant posent le problème des séquelles dues aux thérapeu-tiques appliquées pendant l'odontogenèse. Si les effets iatrogènes des radiations ionisantes sont bien analysés, les répercussions des seuls antimitotiques sur la dentition sont moins connues. C'est pourquoi, afin d'éviter les biais liés à des observations rétrospectives, 13 enfants souffrant en majorité d'une leucémie aiguë lymphoblastique et tous traités par le même protocole chimiothérapique ont été suivis prospectivement ainsi que 11 enfants témoins. L'influence des antimitotiques sur la dentition est abordée sous deux angles : la mesure de la croissance de la deuxième molaire mandibulaire droite, dent choisie en référence, pendant les différentes phases du protocole chimiothérapique puis en rémission et la surveillance de l'apparition d'anomalies dentaires. Le support est l'utilisation d'orthopantomogrammes tirés à intervalles régu-liers après étude du grandissement induit par le générateur. Les résultats convergent vers un ralentissement de la vitesse de minéralisation coronaire de la 47 par la chimiothérapie d'induction-consolidation alors que le rythme radiculaire semble insensible à toutes les phases de chimiothérapie. La non prise en compte possible pour le moment d'éventuels défauts structurels amélo-dentinaires sousestime certainement l'importance des troubles. Cependant déjà, 8 enfants sur 13 ont développé des anomalies dentaires corrélées à la période d'administration des antimitotiques. Les troubles les plus récurrents sont des racines dentaires grêles et/ou courtes (5 enfants) et les agénésies (3 enfants). Quelque soit l'anomalie, la dent la plus fréquemment touchée est la seconde prémolaire. Les atteintes les plus importantes (agénésies, microdonties) concernent les enfants traités les plus jeunes.
SUMMARY
Since the incidence of chemotherapy on developing dentition is poorly documented, 13 children affected by an acute lymphoblastic leukemia and treated by polychemotherapy were assessed versus 11 controls. Measurements of tooth growth as well as dental abnormalities were evaluated. Control X-rays have also been performed before and after unduction-consolidation and 6 months after remission. Significant differences regarding the rythms of the crown mineralization between periods with and without induction-consolidation chemotherapy were found. 8 of 13 children showed altered roots (5 children) and hypodontia (8 children) correlated with the anti-leukemia treatment.The second premolar was the most affected tooth. Furthermore, the effects were more important when the chemotherapy was administrated before the age of 5. However, histological studies are required in order to investigate the effect of chemotherapy on dental structures such as enamel.
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