[Aortic stenosis: An update]

Aortic stenosis remains one of the most frequent valvulopathy worldwide, burdened with great mortality and morbidity, and for which there is not yet an effective preventive approach, although the pathophysiological mechanisms involved in its development are better understood nowadays. Its cure, however, has been revolutionized in the last decade by the advent of transcatheter aortic valve implantation, or TAVI (also named transcatheter aortic valve replacement or TAVR). The technique of TAVI has been refined and its indications has been extended, following the publication of large randomized controlled trials where it was compared to surgical aortic valve replacement with favorable results. Consequently, transfemoral TAVR has become the first line of treatment in case of symptomatic severe aortic valve stenosis. In this review, we describe the pathophysiological mechanisms leading to severe aortic stenosis and the main ongoing randomized controlled trials targeting them. We describe the indication for surgical or percutaneous aortic valve replacement and the main complications following the procedure.

Ankylosis of impacted canines: a retrospective post-surgical study

Ankylosis is generally discovered following resistance to orthodontic displacement of an impacted canine. This retrospective study, drawing on direct perioperative observation of impacted teeth and of their sites, is intended, among other things, to analyze the causes of resistance to orthodontic movement and to report on the therapeutic interest of the surgical tooth displacement technique in this type of clinical situation. We demonstrate that primary coronal ankylosis can be detected by the orthodontic practitioner using radiographic records, that cervical ankylosis consequent to operative trauma during release is necessarily unpredictable and that it should be suspected when the tooth resists traction for more than 3 months in the absence of any other obvious cause of resistance. Hence, the risk of ankylosis linked to the level of surgical difficulty increases with the depth of coronal submergence within the bone. Moreover, the immediate placement of traction following release reduces the risk of ankylosis. In addition, temporarily suspending traction is a risk factor for secondary apical ankylosis. Finally, surgical positioning should be borne in mind as the final effective option when faced with any form of dental retention.