{"id":1132,"date":"2018-04-09T12:11:08","date_gmt":"2018-04-09T16:11:08","guid":{"rendered":"http:\/\/periomontreal.com\/?p=1132"},"modified":"2018-04-09T12:11:08","modified_gmt":"2018-04-09T16:11:08","slug":"utilisation-de-la-matrice-alloderm-pour-le-recouvrement-radiculaire-multiple","status":"publish","type":"post","link":"https:\/\/periomontreal.com\/fr\/2018\/04\/utilisation-de-la-matrice-alloderm-pour-le-recouvrement-radiculaire-multiple\/","title":{"rendered":"Utilisation de la matrice Alloderm pour le recouvrement radiculaire multiple"},"content":{"rendered":"<h1>Pr\u00e9sentation du patient<\/h1>\n<p><a href=\"http:\/\/periomontreal.com\/wp-content\/uploads\/2018\/04\/Picture1.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-1115\" src=\"http:\/\/periomontreal.com\/wp-content\/uploads\/2018\/04\/Picture1-272x300.png\" alt=\"\" width=\"272\" height=\"300\" srcset=\"https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/04\/Picture1-272x300.png 272w, https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/04\/Picture1.png 318w\" sizes=\"auto, (max-width: 272px) 100vw, 272px\" \/><\/a><\/p>\n<ul>\n<li>Homme de 55 ans<\/li>\n<li>Plainte principale: \u201c Je veux r\u00e9parer mes gencives\u201d<\/li>\n<li>Ne prend pas de m\u00e9dicaments<\/li>\n<li>Allergie a la p\u00e9nicilline<\/li>\n<li>Histoire m\u00e9dicale non contributoire<\/li>\n<\/ul>\n<p><!--more-->Un homme de 55 ans s\u2019est pr\u00e9sent\u00e9 avec la plainte principale\u00a0: \u00ab\u00a0Je veux\u00a0 r\u00e9parer mes gencives\u00a0\u00bb. Les dents maxillaires ont \u00e9t\u00e9 pr\u00e9c\u00e9demment trait\u00e9es avec des restaurations de composites de classe V afin de dissimuler les r\u00e9cessions pr\u00e9sentes. Le patient avait une hygi\u00e8ne parodontale acceptable et venait \u00e0 ses rendez-vous de maintenance \u00e0 chaque 3 mois. La r\u00e9cession gingivale \u00e0 de multiples causes incluant, entre autres, le brossage dentaire traumatique, un biotype gingival mince, la plaque dentaire et une position inad\u00e9quate des dents dans l\u2019arche. Les proc\u00e9dures de recouvrement peuvent aider les patients au niveau de l\u2019esth\u00e9tique, \u00e0 avoir une meilleure hygi\u00e8ne buccale et dans certains cas peuvent aussi diminuer la sensibilit\u00e9 dentinaire.<\/p>\n<h1>Observations cliniques<\/h1>\n<p><a href=\"http:\/\/periomontreal.com\/wp-content\/uploads\/2018\/04\/Perio-Case-2-visuals-for-web-and-newsletter.png\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1123\" src=\"http:\/\/periomontreal.com\/wp-content\/uploads\/2018\/04\/Perio-Case-2-visuals-for-web-and-newsletter-300x120.png\" alt=\"\" width=\"300\" height=\"120\" srcset=\"https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/04\/Perio-Case-2-visuals-for-web-and-newsletter-300x120.png 300w, https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/04\/Perio-Case-2-visuals-for-web-and-newsletter.png 400w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p style=\"text-align: left;\">Photo avant:\u00a0R\u00e9cessions gingivales<\/p>\n<ul>\n<li>Multiple l\u00e9sions de classe V en composite, dont certaines d\u00e9fectueuses<\/li>\n<li>R\u00e9cessions gingivales allant de 2 \u00e0 6 mm<\/li>\n<li>Gencive k\u00e9ratinis\u00e9e ad\u00e9quate<\/li>\n<\/ul>\n<p>Ce patient avait de multiples l\u00e9sions de r\u00e9cessions gingivales. Les valeurs des r\u00e9cessions initiales variaient de 2 mm \u00e0 6 mm et la gencive k\u00e9ratinis\u00e9e \u00e9tait ad\u00e9quate. Les dents #15 \u00e0 25 ont \u00e9t\u00e9 trait\u00e9es.<\/p>\n<h1>Observations radiographiques<\/h1>\n<p>Les radiographies ci-dessous d\u00e9montrent un niveau osseux l\u00e9g\u00e8rement diminu\u00e9 et donc des r\u00e9cessions gingivales de classe 3 dans la classification de Miller * (anticipation d\u2019un recouvrement radiculaire partiel).<\/p>\n<p><a href=\"http:\/\/periomontreal.com\/wp-content\/uploads\/2018\/04\/X-RAY-Observations.png\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1124 aligncenter\" src=\"http:\/\/periomontreal.com\/wp-content\/uploads\/2018\/04\/X-RAY-Observations-300x120.png\" alt=\"\" width=\"300\" height=\"120\" srcset=\"https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/04\/X-RAY-Observations-300x120.png 300w, https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/04\/X-RAY-Observations.png 400w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<h1>Diagnostic<\/h1>\n<ul>\n<li>Difformit\u00e9s mucogingivales multiples reli\u00e9es \u00e0 la r\u00e9cession<\/li>\n<\/ul>\n<h1>Plan de traitement<\/h1>\n<ul>\n<li>Phase initiale (D\u00e9tartrage et conseils d\u2019hygi\u00e8ne buccodentaire)<\/li>\n<li>Greffe de recouvrement radiculaire avec l\u2019<em>alloderm<\/em><\/li>\n<li>Entretien de 3 mois<\/li>\n<\/ul>\n<p>Les matrices allodermiques proviennent de la peau de donneurs humains de laquelle l\u2019\u00e9piderme et certaines composantes cellulaires ont \u00e9t\u00e9 retir\u00e9s. La partie dermique est ensuite trait\u00e9e afin d\u2019\u00e9liminer les virus et\u00a0 les bact\u00e9ries et de r\u00e9duire le risque de rejet. Les avantages de ce tissus comprennent: le traitement de la r\u00e9cession, l\u2019ablation de restaurations radiculaires, parfois aussi le traitement de l\u2019hypersensibilit\u00e9 dentinaire, l\u2019\u00e9limination d\u2019un second site chirurgical (le palais),\u00a0 la possibilit\u00e9 de recouvrir une grande r\u00e9gion (voire une arcade compl\u00e8te puisqu\u2019une quantit\u00e9 illimit\u00e9 de mat\u00e9riel est disponible) et le r\u00e9sultat tr\u00e8s esth\u00e9tique puisque la greffe se m\u00e9lange bien avec les tissus gingivaux adjacents.<\/p>\n<h1>Photos pre-operatoires et post-operatoires<\/h1>\n\n\t\t<style type=\"text\/css\">\n\t\t\t#gallery-1 {\n\t\t\t\tmargin: auto;\n\t\t\t}\n\t\t\t#gallery-1 .gallery-item {\n\t\t\t\tfloat: left;\n\t\t\t\tmargin-top: 10px;\n\t\t\t\ttext-align: center;\n\t\t\t\twidth: 50%;\n\t\t\t}\n\t\t\t#gallery-1 img {\n\t\t\t\tborder: 2px solid #cfcfcf;\n\t\t\t}\n\t\t\t#gallery-1 .gallery-caption {\n\t\t\t\tmargin-left: 0;\n\t\t\t}\n\t\t\t\/* see gallery_shortcode() in wp-includes\/media.php *\/\n\t\t<\/style>\n\t\t<div id='gallery-1' class='gallery galleryid-1132 gallery-columns-2 gallery-size-full'><dl class='gallery-item'>\n\t\t\t<dt class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/periomontreal.com\/fr\/2018\/04\/using-alloderm-matrix-multiple-site-root-coverage\/perio-case-2-visuals-for-web-and-newsletter\/'><img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"160\" src=\"https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/04\/Perio-Case-2-visuals-for-web-and-newsletter.png\" class=\"attachment-full size-full\" alt=\"\" aria-describedby=\"gallery-1-1123\" srcset=\"https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/04\/Perio-Case-2-visuals-for-web-and-newsletter.png 400w, https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/04\/Perio-Case-2-visuals-for-web-and-newsletter-300x120.png 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/a>\n\t\t\t<\/dt>\n\t\t\t\t<dd class='wp-caption-text gallery-caption' id='gallery-1-1123'>\n\t\t\t\tPRE-OP\n\t\t\t\t<\/dd><\/dl><dl class='gallery-item'>\n\t\t\t<dt class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/periomontreal.com\/fr\/2018\/04\/using-alloderm-matrix-multiple-site-root-coverage\/post-op\/'><img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"160\" src=\"https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/04\/Post-Op-.png\" class=\"attachment-full size-full\" alt=\"\" aria-describedby=\"gallery-1-1125\" srcset=\"https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/04\/Post-Op-.png 400w, https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/04\/Post-Op--300x120.png 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/a>\n\t\t\t<\/dt>\n\t\t\t\t<dd class='wp-caption-text gallery-caption' id='gallery-1-1125'>\n\t\t\t\tPOST-OP\n\t\t\t\t<\/dd><\/dl><br style=\"clear: both\" \/>\n\t\t<\/div>\n\n<h1>R\u00e9sultat final<\/h1>\n<p>La cl\u00e9 du succ\u00e8s avec l\u2019alloderm est d\u2019avoir une fermeture primaire appropri\u00e9e et une absence de tension au niveau du lambeau mucoperiost\u00e9.<\/p>\n<p>Le r\u00e9sultat final apr\u00e8s 2 ans d\u00e9montre le recouvrement radiculaire obtenu et la stabilit\u00e9 des tissus gingivaux \u00e0 travers le temps. Les r\u00e9cessions post-op\u00e9ratoires varient de 0 mm \u00e0 1 mm. Le patient \u00e9tait satisfait de l\u2019esth\u00e9tique et ne d\u00e9sirait pas de nouvelles classes V.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Pr\u00e9sentation du patient Homme de 55 ans Plainte principale: \u201c Je veux r\u00e9parer mes gencives\u201d Ne prend pas de m\u00e9dicaments Allergie a la p\u00e9nicilline Histoire m\u00e9dicale non contributoire<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[30],"tags":[],"class_list":{"0":"post-1132","1":"post","2":"type-post","3":"status-publish","4":"format-standard","6":"category-nouvelles","7":"entry"},"_links":{"self":[{"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/posts\/1132","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/comments?post=1132"}],"version-history":[{"count":4,"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/posts\/1132\/revisions"}],"predecessor-version":[{"id":1136,"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/posts\/1132\/revisions\/1136"}],"wp:attachment":[{"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/media?parent=1132"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/categories?post=1132"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/tags?post=1132"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}