Research on the contribution of digital flow in endo-oral maxillofacial prosthetic rehabilitation on the quality of life of patients with cancer of the aerodigestive tract "
Research in dentistry will continue through the work of young researchers already begun in the past year, and will continue around the painful body in a qualitative and ethical perspective. The project coordinated by Chloé Mense and Anne Raskin is based on the observation that in cancers of the upper aero-digestive tract (ADT), the vital structures located in these sites are responsible for essential functions such as eating, swallowing, breathing and speaking. They are often diagnosed late and treated invasively. Vulnerable patients with altered and weakened tissues are difficult to rehabilitate with the impression materials used in conventional dentistry. The use of these everyday materials can be very painful for the patient and the removal of the impression very uncomfortable. Moreover, the radiotherapy associated with the treatment of these cancers often leads to a limitation of the mouth opening in these patients, which sometimes makes it impossible to make conventional impressions. The practitioner is then left without a solution, leaving the patient mutilated by his cancer and its treatments, with a very poor quality of life (difficult phonation and elocution, impossible oral feeding, very complicated swallowing of liquids).
The researchers of the project intend to take up the challenge of the use of digital flow (Computer Aided Design - Manufacturing (CADCAM), planning, modeling and design software, impressions via intra-oral scanners) in the realization of maxillofacial implantoprosthetic endo-oral rehabilitations (not or hardly achievable by conventional techniques) in order to improve the comfort of the patients during the impression sessions but also their comfort after the realization of their rehabilitation, during the wearing of the prostheses by the realization of better adapted prostheses This project will benefit from hospital funding, and from the granting of an 8,485 euro scholarship by the Fondation des Gueules Cassées, and from financial aid of 50,000 euros from the Cancéropole PACA 2022 in response to a call for projects.
At the interface with ethics, other researchers in odontology intend to deepen the interdisciplinary projects engaged in the past year around dental anomalies, with a focus on oligodontia which is a rare anomaly of dental development characterized by the agenesis of at least six teeth. This anomaly is a paradigmatic case of the ethical and legal questions that arise in dentistry with regard to its impact on the quality of life of the child affected, on the aesthetic, social, developmental and functional levels. The decision-making process is complex because existing treatments can only partially resolve the associated problems. Moreover, their costs are not fully covered by the community. Faced with this situation, the dental surgeon must respond to strong moral expectations on the part of the parents, arbitrate between
several values, prioritize the patient's needs, and dissociate his or her interest from parental concerns. The research will aim to document the existing literature via qualitative and quantitative surveys on the content of the information delivered by practitioners to prevent a delay in diagnosis with loss of chance.
The legal aspects constitute an unavoidable dimension of the problem if it is true that every person has the right to be informed about his or her state of health, regardless of the health professional who delivers the information, his or her place of practice and the circumstances. Although placed under parental authority as minors, children must participate in decisions that concern them. This norm, which should protect a child's body whose vulnerability is accentuated by pathology, is not integrated to the extent required by the public health code.