Oral Crest Lengthening for Increasing Removable Denture Retention by Means of CO2 Laser
Identifieur interne : 000198 ( Pmc/Checkpoint ); précédent : 000197; suivant : 000199Oral Crest Lengthening for Increasing Removable Denture Retention by Means of CO2 Laser
Auteurs : Samir Nammour [Belgique] ; Elie Gerges [Liban] ; Rima Bou Tayeh [Liban] ; Toni Zeinoun [Liban]Source :
- The Scientific World Journal [ 2356-6140 ] ; 2014.
Abstract
The loss of teeth and their replacement by artificial denture is associated with many problems. The denture needs a certain amount of ridge height to give it retention and a long-term function. Crest lengthening procedures are performed to provide a better anatomic environment and to create proper supporting structures for more stability and retention of the denture. The purpose of our study is to describe and evaluate the effectiveness of CO2 laser-assisted surgery in patients treated for crest lengthening (vestibular deepening). There have been various surgical techniques described in order to restore alveolar ridge height by pushing muscles attaching of the jaws. Most of these techniques cause postoperative complications such as edemas, hemorrhage, pain, infection, slow healing, and rebound to initial position. Our clinical study describes the treatment planning and clinical steps for the crest lengthening with the use of CO2 laser beam (6–15 Watts in noncontact, energy density range: 84.92–212.31 J/cm2, focus, and continuous mode with a focal point diameter of 0.3 mm). At the end of each surgery, dentures were temporarily relined with a soft material. Patients were asked to mandatorily wear their relined denture for a minimum of 4–6 weeks and to remove it for hygienic purposes. At the end of each surgery, the deepest length of the vestibule was measured by the operator. No sutures were made and bloodless wounds healed in second intention without grafts. Results pointed out the efficiency of the procedure using CO2 laser. At 8 weeks of post-op, the mean of crest lengthening was stable without rebound. Only a loss of 15% was noticed. To conclude, the use of CO2 laser is an effective option for crest lengthening.
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DOI: 10.1155/2014/738643
PubMed: 25383385
PubMed Central: 4212588
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Oral Crest Lengthening for Increasing Removable Denture Retention by Means of CO<sub><bold>2</bold></sub> Laser</title><author><name sortKey="Nammour, Samir" sort="Nammour, Samir" uniqKey="Nammour S" first="Samir" last="Nammour">Samir Nammour</name><affiliation wicri:level="4"><nlm:aff id="I1">Department of Dental Sciences, Faculty of Medicine, University of Liege, Liege, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Dental Sciences, Faculty of Medicine, University of Liege, Liege</wicri:regionArea><orgName type="university">Université de Liège</orgName><placeName><settlement type="city">Liège</settlement><region type="region" nuts="1">Région wallonne</region><region type="province" nuts="1">Province de Liège</region></placeName></affiliation></author><author><name sortKey="Gerges, Elie" sort="Gerges, Elie" uniqKey="Gerges E" first="Elie" last="Gerges">Elie Gerges</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Prosthodontic, Faculty of Dentistry, Lebanese University, Beirut, Lebanon</nlm:aff><country xml:lang="fr">Liban</country><wicri:regionArea>Department of Prosthodontic, Faculty of Dentistry, Lebanese University, Beirut</wicri:regionArea><wicri:noRegion>Beirut</wicri:noRegion></affiliation></author><author><name sortKey="Bou Tayeh, Rima" sort="Bou Tayeh, Rima" uniqKey="Bou Tayeh R" first="Rima" last="Bou Tayeh">Rima Bou Tayeh</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of Oral and Maxillo-Facial Surgery, Faculty of Dentistry, Lebanese University, Beirut, Lebanon</nlm:aff><country xml:lang="fr">Liban</country><wicri:regionArea>Department of Oral and Maxillo-Facial Surgery, Faculty of Dentistry, Lebanese University, Beirut</wicri:regionArea><wicri:noRegion>Beirut</wicri:noRegion></affiliation></author><author><name sortKey="Zeinoun, Toni" sort="Zeinoun, Toni" uniqKey="Zeinoun T" first="Toni" last="Zeinoun">Toni Zeinoun</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of Oral and Maxillo-Facial Surgery, Faculty of Dentistry, Lebanese University, Beirut, Lebanon</nlm:aff><country xml:lang="fr">Liban</country><wicri:regionArea>Department of Oral and Maxillo-Facial Surgery, Faculty of Dentistry, Lebanese University, Beirut</wicri:regionArea><wicri:noRegion>Beirut</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25383385</idno><idno type="pmc">4212588</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4212588</idno><idno type="RBID">PMC:4212588</idno><idno type="doi">10.1155/2014/738643</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000781</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000781</idno><idno type="wicri:Area/Pmc/Curation">000781</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000781</idno><idno type="wicri:Area/Pmc/Checkpoint">000198</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000198</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Oral Crest Lengthening for Increasing Removable Denture Retention by Means of CO<sub><bold>2</bold></sub> Laser</title><author><name sortKey="Nammour, Samir" sort="Nammour, Samir" uniqKey="Nammour S" first="Samir" last="Nammour">Samir Nammour</name><affiliation wicri:level="4"><nlm:aff id="I1">Department of Dental Sciences, Faculty of Medicine, University of Liege, Liege, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Dental Sciences, Faculty of Medicine, University of Liege, Liege</wicri:regionArea><orgName type="university">Université de Liège</orgName><placeName><settlement type="city">Liège</settlement><region type="region" nuts="1">Région wallonne</region><region type="province" nuts="1">Province de Liège</region></placeName></affiliation></author><author><name sortKey="Gerges, Elie" sort="Gerges, Elie" uniqKey="Gerges E" first="Elie" last="Gerges">Elie Gerges</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Prosthodontic, Faculty of Dentistry, Lebanese University, Beirut, Lebanon</nlm:aff><country xml:lang="fr">Liban</country><wicri:regionArea>Department of Prosthodontic, Faculty of Dentistry, Lebanese University, Beirut</wicri:regionArea><wicri:noRegion>Beirut</wicri:noRegion></affiliation></author><author><name sortKey="Bou Tayeh, Rima" sort="Bou Tayeh, Rima" uniqKey="Bou Tayeh R" first="Rima" last="Bou Tayeh">Rima Bou Tayeh</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of Oral and Maxillo-Facial Surgery, Faculty of Dentistry, Lebanese University, Beirut, Lebanon</nlm:aff><country xml:lang="fr">Liban</country><wicri:regionArea>Department of Oral and Maxillo-Facial Surgery, Faculty of Dentistry, Lebanese University, Beirut</wicri:regionArea><wicri:noRegion>Beirut</wicri:noRegion></affiliation></author><author><name sortKey="Zeinoun, Toni" sort="Zeinoun, Toni" uniqKey="Zeinoun T" first="Toni" last="Zeinoun">Toni Zeinoun</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of Oral and Maxillo-Facial Surgery, Faculty of Dentistry, Lebanese University, Beirut, Lebanon</nlm:aff><country xml:lang="fr">Liban</country><wicri:regionArea>Department of Oral and Maxillo-Facial Surgery, Faculty of Dentistry, Lebanese University, Beirut</wicri:regionArea><wicri:noRegion>Beirut</wicri:noRegion></affiliation></author></analytic><series><title level="j">The Scientific World Journal</title><idno type="ISSN">2356-6140</idno><idno type="eISSN">1537-744X</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The loss of teeth and their replacement by artificial denture is associated with many problems. The denture needs a certain amount of ridge height to give it retention and a long-term function. Crest lengthening procedures are performed to provide a better anatomic environment and to create proper supporting structures for more stability and retention of the denture. The purpose of our study is to describe and evaluate the effectiveness of CO<sub>2</sub> laser-assisted surgery in patients treated for crest lengthening (vestibular deepening). There have been various surgical techniques described in order to restore alveolar ridge height by pushing muscles attaching of the jaws. Most of these techniques cause postoperative complications such as edemas, hemorrhage, pain, infection, slow healing, and rebound to initial position. Our clinical study describes the treatment planning and clinical steps for the crest lengthening with the use of CO<sub>2</sub> laser beam (6–15 Watts in noncontact, energy density range: 84.92–212.31 J/cm<sup>2</sup>, focus, and continuous mode with a focal point diameter of 0.3 mm). At the end of each surgery, dentures were temporarily relined with a soft material. Patients were asked to mandatorily wear their relined denture for a minimum of 4–6 weeks and to remove it for hygienic purposes. At the end of each surgery, the deepest length of the vestibule was measured by the operator. No sutures were made and bloodless wounds healed in second intention without grafts. Results pointed out the efficiency of the procedure using CO<sub>2</sub> laser. At 8 weeks of post-op, the mean of crest lengthening was stable without rebound. Only a loss of 15% was noticed. To conclude, the use of CO<sub>2</sub> laser is an effective option for crest lengthening.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Sikkerimath, B C" uniqKey="Sikkerimath B">B. C. Sikkerimath</name></author><author><name sortKey="Dandagi, S" uniqKey="Dandagi S">S. Dandagi</name></author><author><name sortKey="Gudi, S S" uniqKey="Gudi S">S. S. Gudi</name></author><author><name sortKey="Jayapalan, D" uniqKey="Jayapalan D">D. Jayapalan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mehanna, M B" uniqKey="Mehanna M">M. B. Mehanna</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Raguse, J D" uniqKey="Raguse J">J. D. Raguse</name></author><author><name sortKey="Gath, H J" uniqKey="Gath H">H. J. Gath</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Karandikar, S" uniqKey="Karandikar S">S. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">ScientificWorldJournal</journal-id><journal-id journal-id-type="iso-abbrev">ScientificWorldJournal</journal-id><journal-id journal-id-type="publisher-id">TSWJ</journal-id><journal-title-group><journal-title>The Scientific World Journal</journal-title></journal-title-group><issn pub-type="ppub">2356-6140</issn><issn pub-type="epub">1537-744X</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25383385</article-id><article-id pub-id-type="pmc">4212588</article-id><article-id pub-id-type="doi">10.1155/2014/738643</article-id><article-categories><subj-group subj-group-type="heading"><subject>Clinical Study</subject></subj-group></article-categories><title-group><article-title>Oral Crest Lengthening for Increasing Removable Denture Retention by Means of CO<sub><bold>2</bold></sub> Laser</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Nammour</surname><given-names>Samir</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Gerges</surname><given-names>Elie</given-names></name><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Bou Tayeh</surname><given-names>Rima</given-names></name><xref ref-type="aff" rid="I3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Zeinoun</surname><given-names>Toni</given-names></name><xref ref-type="aff" rid="I3"><sup>3</sup></xref></contrib></contrib-group><aff id="I1"><sup>1</sup>Department of Dental Sciences, Faculty of Medicine, University of Liege, Liege, Belgium</aff><aff id="I2"><sup>2</sup>Department of Prosthodontic, Faculty of Dentistry, Lebanese University, Beirut, Lebanon</aff><aff id="I3"><sup>3</sup>Department of Oral and Maxillo-Facial Surgery, Faculty of Dentistry, Lebanese University, Beirut, Lebanon</aff><author-notes><corresp id="cor1">*Samir Nammour: <email>s.namour@ulg.ac.be</email></corresp><fn fn-type="other"><p>Academic Editor: Umberto Romeo</p></fn></author-notes><pub-date pub-type="ppub"><year>2014</year></pub-date><pub-date pub-type="epub"><day>14</day><month>10</month><year>2014</year></pub-date><volume>2014</volume><elocation-id>738643</elocation-id><history><date date-type="received"><day>8</day><month>8</month><year>2014</year></date><date date-type="rev-recd"><day>18</day><month>8</month><year>2014</year></date><date date-type="accepted"><day>19</day><month>8</month><year>2014</year></date></history><permissions><copyright-statement>Copyright © 2014 Samir Nammour et al.</copyright-statement><copyright-year>2014</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/3.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>The loss of teeth and their replacement by artificial denture is associated with many problems. The denture needs a certain amount of ridge height to give it retention and a long-term function. Crest lengthening procedures are performed to provide a better anatomic environment and to create proper supporting structures for more stability and retention of the denture. The purpose of our study is to describe and evaluate the effectiveness of CO<sub>2</sub> laser-assisted surgery in patients treated for crest lengthening (vestibular deepening). There have been various surgical techniques described in order to restore alveolar ridge height by pushing muscles attaching of the jaws. Most of these techniques cause postoperative complications such as edemas, hemorrhage, pain, infection, slow healing, and rebound to initial position. Our clinical study describes the treatment planning and clinical steps for the crest lengthening with the use of CO<sub>2</sub> laser beam (6–15 Watts in noncontact, energy density range: 84.92–212.31 J/cm<sup>2</sup>, focus, and continuous mode with a focal point diameter of 0.3 mm). At the end of each surgery, dentures were temporarily relined with a soft material. Patients were asked to mandatorily wear their relined denture for a minimum of 4–6 weeks and to remove it for hygienic purposes. At the end of each surgery, the deepest length of the vestibule was measured by the operator. No sutures were made and bloodless wounds healed in second intention without grafts. Results pointed out the efficiency of the procedure using CO<sub>2</sub> laser. At 8 weeks of post-op, the mean of crest lengthening was stable without rebound. Only a loss of 15% was noticed. To conclude, the use of CO<sub>2</sub> laser is an effective option for crest lengthening.</p></abstract></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>View of the maxilla crest showing a reduced length.</p></caption><graphic xlink:href="TSWJ2014-738643.001"></graphic></fig><fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>View of the operated site during surgery. The site is bloodless. Neither suture nor graft was necessary.</p></caption><graphic xlink:href="TSWJ2014-738643.002"></graphic></fig><fig id="fig3" orientation="portrait" position="float"><label>Figure 3</label><caption><p>The removable denture was temporarily relined with a soft acrylic material until the bottom of the vestibular deepening. Patients were advised to keep the denture in mouth during the 6 weeks of post-op.</p></caption><graphic xlink:href="TSWJ2014-738643.003"></graphic></fig><fig id="fig4" orientation="portrait" position="float"><label>Figure 4</label><caption><p>View of the healed site after 4 weeks post-op. The vestibular lengthening is stable. The healing of the crest was satisfactory.</p></caption><graphic xlink:href="TSWJ2014-738643.004"></graphic></fig><fig id="fig5" orientation="portrait" position="float"><label>Figure 5</label><caption><p>The means and standard deviations of vestibular lengths at the end of surgeries, after 2, 6, and 10 weeks post-op were 15.56 ± 2.72 mm (initial lengths), 14.20 ± 1.9 mm (after 2 weeks of post-op), 11.53 ± 3.1 mm (after 6 weeks), and 11.39 ± 2.6 mm at 10 weeks of post-op. The difference between means of vestibular lengthening in all groups is significantly different except between means of vestibular lengthening after 6 and 10 weeks of post-op. The loss in the initial vestibular deepening continues to increase significantly until 6 weeks post-op and it becomes statically stable.</p></caption><graphic xlink:href="TSWJ2014-738643.005"></graphic></fig><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Results of statistical analysis for all groups are shown. Means are statistically different except for means of vestibular lengthening results at 6 and 10 weeks.</p></caption><table frame="hsides" rules="groups"><tbody><tr><td align="left" rowspan="1" colspan="1">ANOVA test</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"><italic>P</italic> value</td><td align="center" rowspan="1" colspan="1"><0.0001</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"><italic>P</italic> value summary</td><td align="center" rowspan="1" colspan="1">∗∗∗</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1">Are means significantly different? (<italic>P</italic> < 0.05)</td><td align="center" rowspan="1" colspan="1">Yes</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1">Number of groups</td><td align="center" rowspan="1" colspan="1">4</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"><italic>F</italic></td><td align="center" rowspan="1" colspan="1">42,44</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1"><italic>R</italic> square</td><td align="center" rowspan="1" colspan="1">0,3189</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="center" colspan="5" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Newman-Keuls multiple comparison test</td><td align="center" rowspan="1" colspan="1">Mean difference</td><td align="center" rowspan="1" colspan="1"><italic>q</italic></td><td align="center" rowspan="1" colspan="1">Significant? <italic>P</italic> < 0.05?</td><td align="center" rowspan="1" colspan="1">Summary</td></tr><tr><td align="center" colspan="5" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">L-Laser-10 weeks vs L</td><td align="center" rowspan="1" colspan="1">−4.170</td><td align="center" rowspan="1" colspan="1">13.24</td><td align="center" rowspan="1" colspan="1">Yes</td><td align="center" rowspan="1" colspan="1">∗∗∗</td></tr><tr><td align="left" rowspan="1" colspan="1">L-Laser-10 weeks vs L-Laser-2 weeks </td><td align="center" rowspan="1" colspan="1">−2.810</td><td align="center" rowspan="1" colspan="1">8.922</td><td align="center" rowspan="1" colspan="1">Yes</td><td align="center" rowspan="1" colspan="1">∗∗∗</td></tr><tr><td align="left" rowspan="1" colspan="1">L-Laser-10 weeks vs L-Laser-6 weeks </td><td align="center" rowspan="1" colspan="1">−0.1400</td><td align="center" rowspan="1" colspan="1">0.4445</td><td align="center" rowspan="1" colspan="1">No</td><td align="center" rowspan="1" colspan="1">ns</td></tr><tr><td align="left" rowspan="1" colspan="1">L-Laser-6 weeks vs L</td><td align="center" rowspan="1" colspan="1">−4.030</td><td align="center" rowspan="1" colspan="1">12.80</td><td align="center" rowspan="1" colspan="1">Yes</td><td align="center" rowspan="1" colspan="1">∗∗∗</td></tr><tr><td align="left" rowspan="1" colspan="1">L-Laser-6 weeks vs L-Laser-2 weeks </td><td align="center" rowspan="1" colspan="1">−2.670</td><td align="center" rowspan="1" colspan="1">8.477</td><td align="center" rowspan="1" colspan="1">Yes</td><td align="center" rowspan="1" colspan="1">∗∗∗</td></tr><tr><td align="left" rowspan="1" colspan="1">L-Laser-2 weeks vs L</td><td align="center" rowspan="1" colspan="1">−1.360</td><td align="center" rowspan="1" colspan="1">4.318</td><td align="center" rowspan="1" colspan="1">Yes</td><td align="center" rowspan="1" colspan="1">∗∗</td></tr></tbody></table></table-wrap><table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label><caption><p>Sexes and number of succeeded and failed surgeries are shown.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1"> </th><th align="center" rowspan="1" colspan="1">Number of patients</th><th align="center" rowspan="1" colspan="1">Number of succeeded surgeries</th><th align="center" rowspan="1" colspan="1">Number of failed surgeries</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Females</td><td align="center" rowspan="1" colspan="1">41</td><td align="center" rowspan="1" colspan="1">41</td><td align="center" rowspan="1" colspan="1">0</td></tr><tr><td align="left" rowspan="1" colspan="1">Males</td><td align="center" rowspan="1" colspan="1">28</td><td align="center" rowspan="1" colspan="1">25</td><td align="center" rowspan="1" colspan="1">3</td></tr></tbody></table></table-wrap></floats-group></pmc><affiliations><list><country><li>Belgique</li><li>Liban</li></country><region><li>Province de Liège</li><li>Région wallonne</li></region><settlement><li>Liège</li></settlement><orgName><li>Université de Liège</li></orgName></list><tree><country name="Belgique"><region name="Région wallonne"><name sortKey="Nammour, Samir" sort="Nammour, Samir" uniqKey="Nammour S" first="Samir" last="Nammour">Samir Nammour</name></region></country><country name="Liban"><noRegion><name sortKey="Gerges, Elie" sort="Gerges, Elie" uniqKey="Gerges E" first="Elie" last="Gerges">Elie Gerges</name></noRegion><name sortKey="Bou Tayeh, Rima" sort="Bou Tayeh, Rima" uniqKey="Bou Tayeh R" first="Rima" last="Bou Tayeh">Rima Bou Tayeh</name><name sortKey="Zeinoun, Toni" sort="Zeinoun, Toni" uniqKey="Zeinoun T" first="Toni" last="Zeinoun">Toni Zeinoun</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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