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Place De Trichomonas Tenax Et Entamoeba Gingivalis Dans La Maladie Parodontale : État

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Place De Trichomonas Tenax Et Entamoeba Gingivalis Dans La Maladie Parodontale : État http://portaildoc.univ-lyon1.fr Creative commons : Paternité - Pas d’Utilisation Commerciale - Pas de Modification 2.0 France (CC BY-NC-ND 2.0) http://creativecommons.org/licenses/by-nc-nd/2.0/fr SIMO (CC BY-NC-ND 2.0) UNIVERSITÉ CLAUDE BERNARD-LYON 1 U.F.R D’ODONTOLOGIE Année 2021 THÈSE N°2021 LYO 1D 015 T H È S E POUR LE DIPLÔME D’ÉTAT DE DOCTEUR EN CHIRURGIE DENTAIRE Présentée et soutenue publiquement le : 11/03/2021 par SIMO Candice Née le 23 juin 1995 à Villeurbanne (69) ______________ Titre de la Thèse Place de Trichomonas tenax et Entamoeba gingivalis dans la maladie parodontale : état des connaissances actuelles et décryptage d’une proposition de traitement antiparasitaire _____________ JURY Madame Kerstin GRITSCH Présidente Monsieur Olivier ROBIN Assesseur Monsieur Arnaud LAFON Assesseur Madame Doriane CHACUN Assesseure SIMO (CC BY-NC-ND 2.0) UNIVERSITÉ CLAUDE BERNARD-LYON 1 U.F.R D’ODONTOLOGIE Année 2021 THÈSE N°2021 LYO 1D 015 T H È S E POUR LE DIPLÔME D’ÉTAT DE DOCTEUR EN CHIRURGIE DENTAIRE Présentée et soutenue publiquement le : 11/03/2021 par SIMO Candice Née le 23 juin 1995 à Villeurbanne (69) ______________ Titre de la Thèse Place de Trichomonas tenax et Entamoeba gingivalis dans la maladie parodontale : état des connaissances actuelles et décryptage d’une proposition de traitement antiparasitaire _____________ JURY Madame Kerstin GRITSCH Présidente Monsieur Olivier ROBIN Assesseur Monsieur Arnaud LAFON Assesseur Madame Doriane CHACUN Assesseure SIMO (CC BY-NC-ND 2.0) UNIVERSITE CLAUDE BERNARD LYON I Administrateur provisoire M. le Professeur F. FLEURY Président du Conseil Académique M. le Professeur H. BEN HADID Vice-Président du Conseil d’Administration M. le Professeur D. REVEL Vice-Président de la Commission Recherche M. le Professeur J.F MORNEX du Conseil Académique Vice-Président de la Commission Formation Vie Universitaire M. le Professeur P. CHEVALIER du Conseil Académique SECTEUR SANTE Faculté de Médecine Lyon Est Directeur : M. le Professeur G. RODE Faculté de Médecine et Maïeutique Lyon-Sud Directeur : Mme la Professeure C. BURILLON Charles Mérieux Faculté d'Odontologie Directrice : Mme. la Professeure D. SEUX Institut des Sciences Pharmaceutiques et Biologiques Directrice : Mme la Professeure C. VINCIGUERRA Institut des Sciences et Techniques de la Directeur : M. X. PERROT, Maître de Conférences Réadaptation Département de Formation et Centre de Directrice : Mme la Professeure A.M. SCHOTT Recherche en Biologie Humaine SECTEUR SCIENCES ET TECHNOLOGIES UFR des Sciences et Techniques des Directeur : M. Y. VANPOULLE, Professeur Agrégé Activités Physiques et Sportives Institut Universitaire de Technologie Lyon 1 Directeur : M. le Professeur C. VITON POLYTECH LYON Directeur : M. E. PERRIN Institut de Science Financière et d’Assurances Directeur : M. N. LEBOISNE, Maître de Conférences INSPE Administrateur provisoire M. P. CHAREYRON Observatoire de Lyon Directrice : Mme la Professeure I. DANIEL CPE Directeur : M. G. PIGNAULT GEP Administratrice provisoire: Mme R. FERRIGNO Informatique (Département composante) Directeur : M. B. SHARIAT Mécanique (Département composante) Directeur : M. M. BUFFAT UFR FS (Chimie, mathématique, physique) Administrateur provisoire : M. B. ANDRIOLETTI UFR Biosciences (Biologie, biochimie) Directrice : Mme K. GIESELER SIMO (CC BY-NC-ND 2.0) FACULTE D'ODONTOLOGIE DE LYON Doyenne : Mme Dominique SEUX, Professeure des Universités Vices-Doyens : M. Jean-Christophe MAURIN, Professeur des Universités Mme Béatrice THIVICHON-PRINCE, Maître de Conférences SOUS-SECTION 56-01 : ODONTOLOGIE PEDIATRIQUE ET ORTHOPEDIE DENTO-FACIALE Professeur des Universités : M. Jean-Jacques MORRIER, Mme Béatrice THIVICHON-PRINCE Maître de Conférences : Mme Sarah GEBEILE-CHAUTY, Mme Claire PERNIER, Maître de Conférences Associée Mme Christine KHOURY SOUS-SECTION 56-02 : PREVENTION - EPIDEMIOLOGIE ECONOMIE DE LA SANTE - ODONTOLOGIE LEGALE Professeur des Universités M. Denis BOURGEOIS Maître de Conférences M. Bruno COMTE Maître de Conférences Associé M. Laurent LAFOREST SOUS-SECTION 57-01 : CHIRURGIE ORALE – PARODONTOLOGIE – BIOLOGIE ORALE Professeur des Universités : M. J. Christophe FARGES, Mme Kerstin GRITSCH Maîtres de Conférences : Mme Anne-Gaëlle CHAUX, M. Thomas FORTIN, M. Arnaud LAFON, M. François VIRARD Maître de Conférences Associé M. BEKHOUCHE Mourad, Mme Ina SALIASI SOUS-SECTION 58-01 : DENTISTERIE RESTAURATRICE, ENDODONTIE, PROTHESE, FONCTION-DYSFONCTION, IMAGERIE, BIOMATERIAUX Professeurs des Universités : M. Pierre FARGE, Mme Brigitte GROSGOGEAT, M. Jean-Christophe MAURIN, Mme Catherine MILLET, M. Olivier ROBIN, Mme Dominique SEUX, M. Cyril VILLAT Maîtres de Conférences : M. Maxime DUCRET, M. Patrick EXBRAYAT, M. Christophe JEANNIN, Mme Marion LUCCHINI, M. Renaud NOHARET, M. Thierry SELLI, Mme Sophie VEYRE, M. Stéphane VIENNOT , Maîtres de Conférences Associés M. Hazem ABOUELLEIL, SECTION 87 : SCIENCES BIOLOGIQUES FONDAMENTALES ET CLINIQUES Maître de Conférences Mme Florence CARROUEL SIMO (CC BY-NC-ND 2.0) Table des matières Introduction ....................................................................................................................................... 7 Partie 1 : Protozoaires oraux et techniques d’identification ................................................................. 8 1. Présentation de deux parasites oraux suspectés d’être impliqués dans la maladie parodontale 10 Trichomonas tenax ........................................................................................................... 10 Entamoeba gingivalis ....................................................................................................... 11 2. Techniques d’identification parasitaire.................................................................................. 14 Techniques de prélèvements ............................................................................................. 14 Identification microscopique............................................................................................. 14 Identification par PCR ...................................................................................................... 16 Le principe de la PCR conventionnelle simplifié :................................................................. 16 Le principe de la PCR en temps réel simplifié :..................................................................... 22 Partie 2 : Hypothèses d’une implication parasitaire dans la maladie parodontale ............................... 27 1. Définitions, applications et limites de la pathogénicité en microbiologie ............................... 27 Définitions........................................................................................................................ 27 Utilisations des postulats................................................................................................... 29 Les limites de la méthode.................................................................................................. 31 2. Liens entre la maladie parodontale et T. tenax....................................................................... 32 Prévalence orale de Trichomonas tenax............................................................................. 32 Induction d’une réponse immunitaire et reproductibilité sur le modèle animal ................... 32 Impact des traitements parodontaux sur T. tenax ............................................................... 33 Facteurs de virulence et conclusion sur la pathogénicité .................................................... 34 3. Liens entre la parodontite et E. gingivalis ............................................................................. 35 Prévalence orale d’Entamoeba gingivalis, études in vitro et modèle animal....................... 35 Impact des traitements parodontaux sur E. gingivalis ........................................................ 36 Hypothèse sur les facteurs de virulence et pistes d’étude ................................................... 38 Partie 3 : Présentation d’un protocole de traitement antiparasitaire ................................................... 40 1. Antibiotiques........................................................................................................................ 40 Antibiothérapie systémique............................................................................................... 40 SIMO (CC BY-NC-ND 2.0) Le métronidazole.................................................................................................................. 41 La tétracycline et la doxycycline........................................................................................... 41 Antibiothérapie locale....................................................................................................... 42 Le tétrarince : ....................................................................................................................... 42 Les pâtes MA, MC et MK2 :................................................................................................. 43 Recommandations françaises et résistance bactérienne...................................................... 45 2. Phase d’assainissement parodontal du protocole ................................................................... 48 Antiseptiques inspirés de Keyes : eau oxygénée et poudre de Torrens ............................... 48 Élimination mécanique de la plaque dentaire..................................................................... 50 Soins au fauteuil
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