Laurent Nawrocki

Centre Hospitalier Régional Universitaire de Lille, Lille, Nord-Pas-de-Calais, France

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Publications (5)2.33 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Une lésion blanche non détachable de la muqueuse buccale correspond le plus souvent à une kératose de surface. Pour ces lésions à risque de transformation, le traitement reste controversé. Pour évaluer l'efficacité du laser CO2, deux études ont été menées. La première, rétrospective, a porté sur 61 patients présentant 64 lésions traitées sur une période de 17 ans ; la seconde, prospective, a concerné 12 patients présentant 13 lésions, pendant un an. L'âge, le sexe, le praticien référent, le type et le site de la lésion, la présence de dysplasie, un facteur favorisant, la survenue d'une récidive ou d'une transformation maligne ont été recherchés. Le lichen plan touche davantage la femme, tandis que les lésions papillomateuses ou verruqueuses prédominent chez l'homme. Les lésions se situent préférentiellement sur la face interne des joues. Des facteurs favorisants ont été retrouvés (terrain dépressif, tabac, traumatisme, éléments métalliques). Le taux de récidive a été de 26,6 % dans l'étude rétrospective, celui de transformation maligne de 7,8 %. Dans l'étude prospective, ils ont été respectivement de 33,3 % et de 0% (pour la période d'observation). Compte-tenu de ces résultats et des facilités opératoires, et sous couvert d'une biopsie pré-opératoire, l'utilisation du laser CO2 semble être une alternative intéressante aux autres techniques chirurgicales (excision, électrocoagulation, cryothérapie) pour le traitement des lésions superficielles, non dysplasiques. Dans tous les cas, une surveillance régulière et à long terme s'impose. (Med Buccale Chir Buccale 2008 ; 14: 209-219). CO2 laser therapy for oral mucosa lesions remains controversial. The aim of this study is to evaluate the efficacity of CO2 laser therapy for leucokeratosic lesions. Two studies have been carried out: a retrospective analysis of 62 patients over 17 years and a prospective analysis of 12 patients over 1 year. Age, sex, referring practitioner, location and type of the lesions, contributory factors, signs of dysplasia or malignant transformation have been investigated. In both studies lesions have been divided according to their clinical and histological aspects. Women are more affected than men concerning oral lichen planus whereas verrucous or papillomatous lesions are more frequent among men. In the retrospective study, 26.5% of cases have recurred after laser therapy and 7.8% showed a malignant transformation. In the prospective study, 33.3% of cases have recurred but no case of malignant transformation has been found for the one year follow-up. These rates can be compared to the results of other surgical procedures. After a histological examination, CO2 laser therapy seems to be an interesting alternative treatment for non dysplasic leucokeratosic lesions. Notwithstanding, regular check ups over a long period still have to be undertaken. (Med Buccale Chir Buccale 2008 ; 14 : 209-219).
    01/2008; DOI:10.1051/mbcb/2008002
  • 01/2003; DOI:10.1051/mbcb/2003005
  • Journal of Oral and Maxillofacial Surgery 04/2002; 60(3):322-3. DOI:10.1053/joms.2002.30597 · 1.28 Impact Factor
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    ABSTRACT: Chemotherapy administered during childhood may induce dental abnormalities, such as acquired amelogenesis imperfecta, microdontia, hypodontia and altered root morphology. The magnitude of the defect varies according to the cytotoxic agents, the duration of their use and the stage of tooth development at the time of chemotherapy. Patients who received high-dose chemotherapy before the age of 5 are particularly concerned. The dental supervision of these children is based upon three orthopantomograms: the first one has to be performed before starting chemotherapy and will be used as a reference; the second is done soon after the drug therapy in order to evaluate the first consequences; the third is performed after the eruption of all permanent teeth (age 12-13 in average) in order to determine the dental abnormalities. In case of hypodontia, orthodontic treatment must be considered, but it is necessary to take into account the fact that it may increase the risk of root resorption. Preventive dental care is important for these children. It involves meticulous oral hygiene and frequent dental visits to assess and maintain dental health.
    Archives de Pédiatrie 08/2001; 8(7):754-6. · 0.41 Impact Factor
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    ABSTRACT: A prospective study about the development of the mandibular second right molar, has been performed with 17 chemotherapy treated children in the Paediatric Oncology department of the Centre Oscar-Lambret (Lille). Our method is based upon the measure of the crown or root length for different periods: periods with or without chemotherapy. These measurements have been performed every 6 months for 18 months with orthopantomograms. We notice for both the crown and the root: a significant difference in growing speed between periods with an without chemotherapy; a speeding up of the mineralization at the end of the treatment rejoining the average figures of a healthy test population.
    Bulletin du cancer 02/1995; 82(1):46-50. · 0.64 Impact Factor