Академический Документы
Профессиональный Документы
Культура Документы
Année 2016 Thèse n° 4257-1631
!$!-%%29,
Née le 22 septembre 1989 à Cannes
Pour obtenir le grade de :
Examinateurs
e
f
REMERCIEMENTS
Vous m’avez prodigué tout au long de mon internat, votre science et votre
savoir. J’ai la chance d’être à vos côtés depuis deux ans et je ne cesse
d’apprendre et de progresser grâce à votre disponibilité, votre enseignement,
vos précieux conseils et votre dynamisme.
Vos qualités professionnelles et votre rigueur sont pour moi des exemples à
suivre. Veuillez trouver par ce travail l’expression de ma gratitude la plus
sincère et de ma plus haute considération.
g
A Madame le Professeur Laurence LUPI-PEGURIER
Docteur en chirurgie dentaire
Docteur de l’Université de Nice Sophia-Antipolis
Professeur des Universités, Praticien hospitalier
Responsable de la sous-section Prévention, Epidémiologie, Economie de
la santé, Odontologie légale.
Je vous suis très reconnaissante d’avoir accepté sans hésitation de faire partie
de ce jury et j’en suis honorée. Vos compétences en chirurgie maxillo-faciale
ont rendu notre formation plus exhaustive et nous ont ouvert les voies d’un
travail d’équipe plaisant et formateur.
Merci également pour votre dévotion et votre gentillesse.
h
SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSk
S?%(-(3(.-2SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSk
SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSk
#$-3 (1$SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSk
204$+$33(04$SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSl
S (,(3$2#424)$3SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSed
S
-#(" 3(.-2$3".-31$T(-#(" 3(.-2#431 (3$,$-3.13'.#.-3(04$#$"+ 22$
/ 1
31 "3(.-2(-3$1, 7(++ (1$22 -2$731 "3(.-SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSee
SeS
-#(" 3(.-2SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSee
SfS.-31$T(-#(" 3(.-2SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSee
R
".11$"3(.-#$+ "+ 22$
SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSeh
SfS
$2$%%$32#$2
#$"+ 22$
SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSei
SfSeS%%$32#$2
#$"+ 22$
SfSfS%%$32#$2
#$"+ 22$
SfSgS%%$32241+$2"'?, % "( +SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSem
SfShS%%$32.13'./?#(04$2SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSem
SfSiS%%$32241+V 13("4+ 3(.-3$,/.1.T, -#(!4+ (1$SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSem
i
SgS//1."'$"?/' +.,?31(04$SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSgi
SgSeS$+.-+V - +82$#$SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSgi
SgSfS$+.-+V - +82$#$
SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSgm
SgSgS$+.-+V - +82$#$
SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSShi
SgShS(2"422(.-SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSShk
SeS1(-"(/$2!(.,?" -(04$2SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSif
SeSe.-31E+$#(1$"3R/1?2$-3 3(.-#43.104$SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSif
SfS//+(" 3(.-2"+(-(04$2SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSjj
SfSeS-"1 &$$-3$"'-(04$#&$6(2$SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSjj
SfSfS-"1 &$$-3$"'-(04$(./1.&1$22(5$SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSkh
SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSlm
SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSme
SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSmi
j
$31 (3$,$-3#$+ , +.""+42(.-#$"+ 22$
A. Définitions
$231$2/$"3(5$,$-3#$-3 (1$$3Y.4204$+$33(04$S
++$2$1?%>1$: l "+ 22(%(" 3(.-#a
\g]04(2$! 2$241#$21 //.132#a.""+42(.-$-
(-3$1"42/(# 3(.-, 7(, +$S
-2 + "+ 22$
#V
P + "42/(#$ ,?2(.T5$23(!4+ (1$ #$ + /1$,(>1$ ,.+ (1$
, 7(++ (1$$231$=4$# -2+$2(++.-5$23(!4+ (1$#$+ /1$,(>1$,.+ (1$, -#(!4+ (1$S
-1$5 -"'$P+ "+ 22$
T
#(5(2(.-#$+ "+ 22$
S
k
+ 22$
)'52%VJ
,,5342!4)/.$%,!#,!33%
$)6)3)/.V
+ 22$
)'52%WJ
,,5342!4)/.$%,!#,!33%
$)6)3)/.W
/1?"(2$04$+ "+ 22$
/$43@31$ 28,?31(04$$3-$".-"$1-$104V4-2$4+"E3?P.-
/ 1+$ +.12#$"+ 22$
24!#(5(2(.-#1.(3$.4& 4"'$S
$2 1$+ 3(.-2 #$2 ! 2$2 .22$42$2 # -2 +$ 2$-2 2 &(33 + -$ ".11$2/.-#$-3 / 2
-?"$22 (1$,$-3 47 1$+ 3(.-2 .""+42 +$2S
"+ 22(%(" 3(.- #$
5($-3 +.12
".,/+?3$1+ "+ 22(%(" 3(.-#V
S
V /1>2
P +$ #?" + &$ #$2 ! 2$2 .22$42$2 /$43 @31$ //1?"(? 241 4-$
3?+?1 #(.&1 /'($ #$ /1.%(+ / 1 +$ 31 "? #$ +V -&+$ \(&41$ g]S ( "$3 -&+$ $23
24/?1($41:huP.-/ 1+$#$"+ 22$
204$+$33(04$S
l
$2"+ 22$2
315%,%44)15%K
m
$33$ ,$241$ $23 #.-" 2.45$-3 ".-%1.-3?$ : #V 431$2 5 +$412P -.3 ,,$-3 "$++$ #$
+V(-#("$ #$(32 #$ \i]S V$23 +V?34#$ #$ + #(23 -"$ 04( 2?/ 1$ +$2
/1.)$"3(.-2.13'.&.- +$2#$2/.(-32$3#$241+$/+ -.""+42 +\(&41$i]S($23
24/?1($41:f,,P+$#?" + &$#$"+ 22$
204$+$33(04$$23".-%(1,?S
)'52%ZJ%02>3%.4!4)/.$%,M).$)#%$%)43$%RZS
$33$ ,$241$ +($ +$2 , 7(++ (1$2 $-31$ $47 2 -2 3$-(1 ".,/3$ #V4-$ 1?%?1$-"$ "1 -(.T
% "( +$S
+ % 43 "$/$-# -3 & 1#$1 : +V$2/1(3 04$ "$33$ ,$241$ $23 (-%+4$-"?$ / 1
+V.1($-3 3(.-#4/+ -#V.""+42(.-Q4-$! 2"4+$$-' 43$3$- 5 -3#$"$/+ - 4&,$-3$+
5 +$41#$\$3(-5$12$,$-3]S
B. Limites du sujet
-2 +$ " #1$ #$ "$ 31 5 (+P -.42 -.42 (-3?1$22.-2 $7"+42(5$,$-3 47 31 (3$,$-32
.13'.#.-3(04$2 #$ + "+ 22$
W#$-3 (1$XS
+ $7(23$ # -2 + +(33?1 341$ #$ -.,!1$42$2
3$"'-(04$2#?"1(3$2,$33 -3$-/+ "$#(5$1238/$2#V // 1$(+2/.41+ 31 (3$1S$/$-# -3P
-.42-.42%." +(2$1.-2241+ 3'?1 /$43(04$/ 1?+ 23(04$2(-3$1, 7(++ (1$2#$"+ 22$
P
2 -2$731 "3(.-#$/1?,.+ (1$2S
ed
C. Indications et contre-indications du traitement orthodontique de
classe II par tractions intermaxillaires sans extraction
C. 1. Indications
$ 31 (3$,$-3 .13'.#.-3(04$ #$ + "+ 22$
2.42
%.1,$#V?+ 23(04$2(-3$1, 7(++ (1$2[2 -2$731 "3(.-#$/1?,.+ (1$2[2V #1$22$ 47" 2
/.45 -3@31$31 (3?2/ 12(,/+$".,/$-2 3(.- +5?.+.T#$-3 (1$+.1204$R
-
$2 1" #$22.-31?&4+(>1$2.4/1?2$-3$-3#$2#( 23>,$2Q
-
V 1" #$, -#(!4+ (1$-$-?"$22(3$/ 2#$".11$"3(.- -3?1($41$(,/.13 -3$\j]Q
-
V$-".,!1$,$-3$23% (!+$.4-4+Q
-
".41!$#$/$$$23% (!+$.4,.#?1?$Q
-
$2(-"(2(5$2, -#(!4+ (1$2-$-?"$22(3$-3/ 2#$1$/.2(3(.--$,$-3+(-&4 +Q
-
$2 , +/.2(3(.-2 /$45$-3 @31$ ".11(&?$2 / 1 $7/ -2(.- 31 -25$12 +$ $3Y.4
2 &(33 +$Q
-
V$23'?3(04$ % "( +$ $23 ' 1,.-($42$P 5$" 4- /1.%(+ 2.42T- 2 + : ".-5$7(3?
,.#?1?$P$-/ 13("4+($1"'$9+$2!1 "'8% "( 47\h]S
C.2. Contre-indications
$/$-# -3P# -24-"$13 (--.,!1$#$" 2P+ ".11$"3(.-#4#?" + &$2 &(33 +#$2 1" #$2
#$-3 (1$2 -$ /.411 @31$ 4-(04$,$-3 .!3$-4$ / 1 #$2 31 "3(.-2 ?+ 23(04$2 \2 -2
$731 "3(.-]S
-
V$-".,!1$,$-3 , -#(!4+ (1$ $23 (,/.13 -3 5$" 4-$ #82' 1,.-($ #$-3.T
, 7(++ (1$\tm,,].44-$#82' 1,.-($#$-3.T#$-3 (1$Q
- -$ ".41!$ #$ /$$ $7"$22(5$,$-3 , 104?$ #.-3 +$ -(5$++$,$-3 -$ /$43
2V$%%$"34$1# -2+$2+(,(3$2/'82(.+.&(04$2#$+ #$-341$Q
- -$ 5$12(.- ".1.-.T5$23(!4+ (1$ $7"$22(5$ #$ +V(-"(2(5$ , -#(!4+ (1$
".,/1.,$33 -32.-".-3$73$/ 1.#.-3 +Q
- - #?" + &$ ".-2?04$-3 2 -2 "1.(22 -"$ 1?2(#4$++$P .F #$2 $731 "3(.-2 #$
/1$,(>1$2 /1?,.+ (1$2 , 7(++ (1$2 2.-3 /1?%?1 !+$2 \ !2$-"$ #$ 1(204$
$23'?3(04$, )$41]/.414-$%(-(3(.-$-"+ 22$
#(3$3'?1 /$43(04$S
ee
ef
!#/22%#4)/.$%,!#,!33%
0!242!#4)/.3
).4%2-!8),,!)2%3
0# $#*!%#$#!%#0
eg
J
!#/22%#4)/.$%,!#,!33%
0!242!#4)/.3).4%2-!8),,!)2%3R
S
)'52%[J2!#4)/.).4%2-!8),,!)2%$%#,!33%
R0/3)4)/..%-%.4,%0,53#/52!.4S
$2 ?+ 23(04$2 2.-3 ,(2 $3 $-+$5?2 / 1 +$ / 3($-3S
+2 2.-3 1$-.45$+?2 /+42($412 %.(2 / 1
).41$-%.-"3(.-#$+ /1$2"1(/3(.-\/.13#(41-$P-."341-$.4".,!(-?]S
".,/.2(3(.-?+ 23(04$#$"$231 "3(.-2(-3$1, 7(++ (1$2$-31 (-$4-$#?3?1(.1 3(.-$3
4-$/$13$#$+ ,?,.(1$?+ 23(04$" 42?$2/ 1+$/ $3+V$-5(1.--$,$-3!4"" +\+ 2 +(5$P
+ -.411(341$P+$2!.(22.-2$3+ /+ 04$#$-3 (1$]S
/1>2 f' $- !.4"'$P +$ ,.#4+$ #$ %.1"$ ?+ 23(04$ #?"1.(3 #$ gdp $3 #$ /+42 #$ hdp
/1>2g'S$/+42P 5$"+$3$,/2P(+22$&.-%+$-3$3#$5($--$-3.#.1(%>1$2\l]S
eh
$2 ?+ 23(04$2 #.(5$-3 #.-" @31$ "' -&?2 1?&4+(>1$,$-3 /.41 , (-3$-(1 4-$ 31 "3(.-
".-23 -3$S
$41 " 1 "3>1$ ,.5(!+$(,/+(04$ 4-$ ".,/+( -"$ $3 4-$ "../?1 3(.- (,/.13 -3$2 #4
/ 3($-3S ( + /1$2"1(/3(.-P -.3 ,,$-3 +$41 /.2(3(.--$,$-3P -V$23 / 2 1$2/$"3?$P #$2
%.1"$2(,/1?54$2$3(-#?2(1 !+$2/$45$-3@31$$7$1"?$2S
+ % 43 2.4+(&-$1 04$ +$2 ,.45$,$-32 , -#(!4+ (1$2 $7"412(%2 4&,$-3$-3 +$412
?3(1$,$-32 $3 #.-" + %.1"$ #?+(51?$ \, 23(" 3(.-P /'.- 3(.-]S -2 "$2 ,.,$-32 #$
#8- ,(04$ , -#(!4+ (1$P +$2 %.1"$2 $7$1"?$2 2.-3 (-".-23 -3$2P 5$" 4-$ ".,/.2 -3$
5$13(" +$, ).1?$P1(204 -3#V 4&,$-3$1+$2$%%$32/ 1 2(3$2(-#?2(1 !+$2S
$ -.,!1$47 43$412 .-3 3$-3? #$ #?%(-(1 + %.1"$ ./3(, +$ /.41 +$ #?/+ "$,$-3
#$-3 (1$P %(-04$"$#$1-($12.(3+$/+421 /(#$/.22(!+$2 -2@31$( 31.&>-$S
- emifP $3
?5.04$-3 #$2 %.1"$2 #$ +V.1#1$ #$ eidTfdd& +.12 #V?34#$
241+$1$"4+" -(-\m]S
+42 1?"$,,$-3P #$2 ?34#$2 /.13 -3 2/?"(%(04$,$-3 241 +$2
#$ "+ 22$
?5.04$-3
4-$%.1"$,.8$--$#$kgPk&\ed[eh]S
?-?1 +$,$-3P (+ $23 #,(2 04$ + %.1"$ /1$2"1(3$ \ --.-"?$ / 1 +$ % !1(04 -3] $23
.!3$-4$+.1204$+V?+ 23(04$$23?3(1?#$g%.(22.-#( ,>31$\k]S
).43.-2$-%(-04$+$/.13/1.+.-&?#V?+ 23(04$2#$"+ 22$
/$43@31$:+V.1(&(-$#V4-$
.""+42(.-#$".-5$- -"$\#4 +!(3$.4#.4!+$
]R+$/ 3($-32(,4+$4-$".11$"3(.-#$
+ , +.""+42(.-:+ %$1,$341$!4"" +$S
/ 1
".,/$-2 3(.- #$-3.T +5?.+ (1$S
+ $23 ?3 !+( # -2 + +(33?1 341$ 04$ !($- 04$ +$2
?+ 23(04$2 (-3$1, 7(++ (1$2 #$ "+ 22$
ei
I.2.1. Effets des TIM de classe II sur les arcades dentaires
)'52%\J&&%43$%3
$%#,!33%
352,%3!2#!$%3$%.4!)2%3
$2$%%$32#$2
#$"+ 22$
ej
1 $7$,/+$ \(&41$ l]P $- .""+42(.-P 2( "$3 ?+ 23(04$ % (3 4- -&+$ #$ fdu 5$" +V 1"
".-3(-4$32(+ %.1"$$7$1"?$$23#$edd&\$-5(1.-e]P+ 31 "3(.-2$#?".,/.2$$-R
- -$%.1"$:".,/.2 -3$'.1(9.-3 +$#$edd7".2fdurmgPmd&
- -$%.1"$:".,/.2 -3$5$13(" +$#$edd72(-fdurghPfd&
)'52%]J&&%43$%3
$%#,!33%
%./##,53)/.
.(-3 #V //+(" 3(.- " -(- , 7(++ (1$$3 f-#$ ,.+ (1$ : + , -#(!4+$ \f]R $-
.""+42(.-P +V -&+$ $-31$ +V?+ 23(04$ $3 +V 1" #(,(-4$P + #(231(!43(.- #$2 %.1"$2
,.-31$ +.124-$".,/.2 -3$'.1(9.-3 +$/+42(,/.13 -3$$34-$#(,(-43(.-#$
+ ".,/.2 -3$ 5$13(" +$ #V$73142(.-S $/$-# -3P $- 1 (2.- #$ + /.2(3(.-
3$1,(- +$ #$ fP $3 #4 /$4 #$ +.-&4$41 #$ %(+ (-".1/.1? # -2 +$ 34!$P +V 1"
".-31E+$1 ,.(-2+$2,.45$,$-32#$,?2(.5$12(.-$3#$1.3 3(.-#$"$33$#$-3S
$/+42P+V$%%$3#$! 2"4+$#4/+ -#V.""+42(.-$23 4&,$-3?\"%S"(T /1>2]S
.(-3 #V //+(" 3(.- " -(- , 7(++ (1$ $3 f-# /1?,.+ (1$ : + , -#(!4+$R "$2
31 "3(.-2 #$ "+ 22$
#(3$2 W".413$2X (-23 41$-3 4-$ ".,/.2 -3$ 5$13(" +$ /+42
(,/.13 -3$04(".-31(!4$:/ 1% (1$+$2$-25$13(" +# -2"$13 (-$22(34 3(.-2S
V /1>2 4-$ ?34#$ ,$-?$ $- fddk / 1 $3 +SP $,/+.8 -3 #$2 ,$241$2
31(#(,$-2(.--$++$2P +$ "$-31$ #$ 1?2(23 -"$ #$2 1" #$2 #$-3 (1$2 ?3? #?3$1,(-? $-
1$& 1# #$ + 2$".-#$ /1?,.+ (1$ 4 , 7(++ (1$ $3 $-31$ + 2$".-#$ /1?,.+ (1$ $3 +
/1$,(>1$,.+ (1$:+ , -#(!4+$\ej]\(&41$m]S
ek
)'52%^J/3)4)/.$%3#%.42%3$%2>3)34!.#%$%3!2#!$%3$%.4!)2%3RV[SK
$2 /.(-32 #V -"1 &$ #$2 ?+ 23(04$2 #$ "+ 22$
#/524%3%4,/.'5%3H>45$)>%3%,/.,!$)34!.#%%.42%,!,)'.%$M!#4)/.
$%,!&/2#%>,!34)15%%4,%3#%.42%3$%2>3)34!.#%$%3!2#!$%3$%.4!)2%3
el
I.2.3. Effets sur le schéma facial
-V$- $-31 (-$-3 / 2 #$ % =.- 2(&-(%(" 3(5$S $/$-# -3P : +.-&
3$1,$P+$2$%%$32#$2#$47#(2/.2(3(%2-$,.-31$-3 4"4-$#(%%?1$-"$2(&-(%(" 3(5$Q+V(224$
#431 (3$,$-3#$+ "+ 22$
\fd]S
em
-fdehP4-$?34#$"'(-.(2$\fe]".,/ 1$+$1$,.#$+ &$".-#8+($-"'$9+$2/ 3($-32
31 (3?2/ 1
#$"+ 22$
4&,$-3$-3
2(&-(%(" 3(5$,$-3+$#( ,>31$".-#8+($-S$/$-# -3P 4"4-$#(%%?1$-"$2(&-(%(" 3(5$-V$23
,(2$$-?5(#$-"$+.12#$+ ".,/ 1 (2.- 5$"+$6(-+."*S
-fddkP4-$?34#$#$
\ff]".,/ 1$+ /.2(3(.-#4".-#8+$#$2/ 3($-32
31 (3?2/ 1
#$"+ 22$
)'52%VVJ
.#)$%.#%$%3'2/50%3>,!34)15%3R)0$'%SH %4
352,!0/3)4)/.#/.$9,)%..%%4$50/'/.)/.RWWS
".,/ 1 (2.-#4&1.4/$
4&1.4/$".-31E+$,.-31$4-$ !2$-"$#$#(%%?1$-"$
2(&-(%(" 3(5$#$+ /.2(3(.-".-#8+($--$:j,.(2P3 -#(204V4-$5$13(" +(2 3(.-#$+
/.2(3(.-".-#8+($--$\#?% 5.1 !+$:+ ".11$"3(.-#$+ , +.""+42(.-]$23.!2$15?$:
fPj -2S
".,/ 1 (2.-#4&1.4/$
4&1.4/$ ,.-31$:j,.(2\%(-#431 (3$,$-3
.13'./?#(04$]$3:fPj -2\%(-#431 (3$,$-3.13'.#.-3(04$]4-$/.2(3(.-".-#8+($--$
/+422 &(33 +$# -2+$&1.4/$ $3/+425$13(" +$# -2+$&1.4/$
S
- ".-"+42(.-P +$2
#$ "+ 22$
S
fd
M
0$%"#%)$$ "* *$"!%0
fe
J
!0/3)4)/.)$>!,%$%,M).#)3)6%-!.$)"5,!)2%
.43 4 +.-& #4 31 (3$,$-3 .13'.#.-3(04$ #$ + "+ 22$
S
$2 1?/$1"422(.-2 (-"(2(5$2 -.- ".-31E+?$2\5$23(!4+.5$12(.- , -#(!4+ (1$ $3 / + 3.T
5$12(.- , 7(++ (1$] /$45$-3 "1?$1 4-$ (-3$1%?1$-"$ -3?1($41$ -."(5$ /.41 + /1.&1$2T
2(.- #4 31 (3$,$-3 \] \fg] 5$" #$2 (-"(2(5$2 4 ".-3 "3 $-
S %%$"3(5$,$-3P
, +&1?+V !2$-"$#$241/+.,!P+$21 //.132+ 3?1 47#$"+ 22$
/$12(23$-3S
ff
/ 31.-/.41+V 1" #$, 7(++ (1$S1P+ +(,(3$ -3?1($41$#$+ , -#(!4+$$231$/1?2$-3?$
/ 1+ /.2(3(.-#$+V(-"(2(5$(-%?1($41$# -2+ 28,/'82$\(&41$ef]S
)'52%VWJ
)-)4%!.4>2)%52%$%,!$%.452%
'!5#(%J)-!'%$M5.%39-0(93%%&&),>%H,M).#)3)6%2%0/3%352,%"/2$350>2)%52/A0%5$M/3
!,6>/,!)2%,M%.4/52%K/54$>0,!#%-%.4/24(/$/.4)15%;#%.)6%!5$%62!?42%")%.#/.42@,>K
$2/)4%J)-!'%$M5.%39-0(93%!22/.$)%H,M).#)3)6%).&>2)%52%9%34")%.#%.42>%H,M/3
!,6>/,!)2%15),M%.4/52%%340,53!"/.$!.4RWYSK
$% (3P2$+.-"$2 43$412P1$2/$"3$1"$33$+(,(3$$234-.!)$"3(%%.-# ,$-3 +P& 1 -3#$+
23 !(+(3? $3 #$ + 04 +(3? #4 1?24+3 3 $23'?3(04$S
V(-"(2(5$ , -#(!4+ (1$ /$43 #.-" @31$
".-2(#?1?$".,,$+ "+?#$5.G3$#$+V.""+42(.-S
fg
)'52%VXJ
%3).#)3)6%33/.43)45>%3%.42%,%3,=62%3%4
,!,!.'5%15)%8%2#%.4$%302%33)/.3/00/3>%3RWZS
$2 1" #$2#$-3 (1$22$2(34$-3#.-"# -24-$9.-$#V?04(+(!1$#$2/1$22(.-2 //$+?$
/ 1 +$ W".4+.(1#$-3 (1$X \(&41$ eh] \fj]P .4 $-".1$ W9.-$ -$431$X / 1
PW9.-$" +,$X/ 1
$3W9.-$9?1.X#$S
fh
04(+(!1$-$41.T,42"4+ (1$$338/.+.&($5$13(" +$R
- emil \fk]P
#?"1(3 +a$-5$+.//$ %.-"3(.--$++$ %.1,?$ #$ 31.(2 &1.4/$2
,42"4+ (1$2 \(&41$ ei] 04( 1?&(22$-3 + /.2(3(.- #$ + , -#(!4+$ $3 #?%(-(22$-3 +$2
, 31("$2 %.-"3(.--$++$2 04( ,.#>+$-3 +$2 2314"341$2 204$+$33(04$2 $3 #?3$1,(-$-3 +
/.2(3(.-#$+ #$-341$R
eS
$2,42"+$2#$+ /.2341$#$+ 3@3$P,42"+$2, 23(" 3$412$3,42"+$2#$+ + -&4$
04(%.1,$-34-$"' B-$"(1"4+ (1$ 43.41#$+ 3@3$\]Q
fS
$2,42"+$2"$-31 47#$+ &.1&$$3#45.(+$#4/ + (204((-3$15($--$-3 4".412
#$+ 5$-3(+ 3(.-$3#$+ #?&+43(3(.-\]Q
gS
$2,42"+$2/?1(/'?1(04$2(-"+4 -3+$2+>51$2$3+$!4""(- 3$41\]S
)'52%VZJ
%3'2/50%3-53#5,!)2%33%,/.
fi
)'52%V[J30)2!4)/.$%,!,=62%).&>2)%52%H3),,/.,!")/L-%.4/..)%2-!215>H
(90%2!#4)6)4>"5##).!42)#%#(%:5.0!4)%.4"2!#(9&!#)!,
(%: ,% $/,)#(/&!#)!, \.4 '8/$1#(5$1&$-3]P + ,42"4+ 341$ % "( +$ $23 '8/.T
3.-(04$P +$2 ,.45$,$-32 #$ 5$23(!4+.5$12(.- #$2 (-"(2(5$2 2$1.-3 /+42 (2?2
\+>51$2 3.-$2]\(&41$ek]S
)'52%V\J/.42!#452%,!")/L-%.4/..)=2%;,M/##,53)/.,!")!,%&/2#>%H
,=62%3>0!)33%3%4(90/4/.)15%3#(%:5.0!4)%.4$/,)#(/&!#)!,
fj
II.2.2. Fonctions occlusales : rôle dans le guidage antérieur
/.2(3(.- #$2 (-"(2(5$2 , -#(!4+ (1$2 #.(3 @31$ # /3?$ 4 &4(# &$ -3?1($41 +.12 #4
,.45$,$-3, -#(!4+ (1$#$/1./4+2(.-S
$2?34#$2#$/'82(.+.&($.""+42 +$.-3,.-31?
.12#4,.45$,$-3#$/1./4+2(.-P+$2".-#8+$2, -#(!4+ (1$22$#?/+ "$-3$-24(5 -3
+a?,(-$-"$ 3$,/.1 +$ \+$41 31 )$3 ".-23(34$ + /$-3$ ".-#8+($--$] $3 +$2 (-"(2(5$2
(-%$1($41$224(5$-3+ % "$+(-&4 +$#$2(-"(2(5$224/?1($41$2\"a$23+ /$-3$(-"(2(5$]S
-1? +(3?P+$2(-"(2(5$224/?1($41$2-$".-23(34$-3/ 24-/+ -#$&+(22$,$-3P, (24-$
2.41"$#a(-%.1, 3(.-/1./1(."$/3(5$04((-#4(3+$#?/+ "$,$-3#$+ , -#(!4+$\fi]S
.12 #4 ,.45$,$-3 #$ /1./4+2(.-P +$2 .""+42.#.-3(23$2 2V "".1#$-3 : ".-# ,-$1
+a.""+42(.-! + -"?$$3$23(,$-304V(+-$#.(3/ 28 5.(1#$".-3 "32,.+ (1$2S
$2 (-"(2(5$2 .-3 #.-" "$ 1E+$
2a ! (22$1$-,@,$3$,/204a$++$2V 5 -"$S
(-2(P 2$+.- \fl]R W /+ "$1 +$2 (-"(2(5$2 #$ 3$++$ % =.- 04a$++$2 /1.5.04$-3 +
2?/ 1 3(.-\W#(2"+42(.-X]#$2 1" #$2$234-.!)$"3(%#431 (3$,$-3.13'.#.-3(04$X
\(&41$el]S
)'52%V]J/.#4)/.).#)3)6%%4'5)$!'%!.4>2)%52
J,!0%.4%).#)3)6%%34#/524%H%,,%#/.6)%.4;$%3!2#!$%3")%.
.)6%,>%3!6%#$%3#530)$%30%5-!215>%3I
J5.%0%.4%).#)3)6%0,53,/.'5%%34.>#%33!)2%0/523>0!2%2,%3
-/,!)2%33)5.%!2#!$%%34-!,.)6%,>%H/53),%3#530)$%33/.43!),,!.4%3
R#%3#(>-!.%4)%.40!3#/-04%$%,!0%.4%#/.$9,)%..%SRV\S
fk
II.2.3. Facteur parodontal : rôle dans l’apparition de récession gingivale
V(-"(2(5$ #.(3 2$ 31.45$1 # -2 4-$ 9.-$ 24%%(2 -3$ #$ &$-"(5$ 33 "'?$P ?+.(&-?$ #$ +
".13(" +$ $73$1-$S .43$%.(2P +$ 1E+$ #4 #?/+ "$,$-3 .13'.#.-3(04$ #$2 (-"(2(5$2
, -#(!4+ (1$2# -2+V // 1(3(.-#$1?"$22(.-&(-&(5 +$$23".-31.5$12?S
- fdedP 4-$ 1$54$ 2823?, 3(04$ \fm] ?5 +4$ +$2 ".-2?04$-"$2 / 1.#.-3 +$2 #4
"' -&$,$-3 #$ /.2(3(.- #$2 (-"(2(5$2P (-"+4 -3 422( !($- #$2 ?34#$2 -(, +$2 04$ #$2
?34#$2 '4, (-$2 $3 //.13$ #$2 ".-"+42(.-2 ?5 2(5$2S
$2 43$412 #$ "$33$ 1$54$
(-2(23$-3#V !.1#241+$% (304$+$-(5$ 4#$/1$45$2#$2?34#$22?+$"3(.--?$2$23% (!+$S
$2 2(7 ?34#$2 -(, +$2 ,.-31$-3 04V(+ 8 /+42 #$ 1?"$22(.- &(-&(5 +$ 241 +$2 (-"(2(5$2
#?/+ "?$2 / 1 1 //.13 47 #$-32 3?,.(-2S
V.2 2$ #?/+ "$ $- #(1$"3(.- /(" +$P , (2 +
&$-"(5$ -$ 24(3 / 2 3.4).412 +$ ,.45$,$-3P $- 3.43 " 2 4 #?!43S
$2 .-9$ ?34#$2
"+(-(04$2 ,.-31$-3 04$ + 3$-# -"$ : + 1?"$22(.- $23 /+42 , 104?$ 241 +$2 (-"(2(5$2
5$23(!4+.T5$12?$2.4#?/+ "?$2$-#$'.12#$+V$-5$+.//$.22$42$ +5?.+ (1$S$/$-# -3P
#$2 $22 (2 1 -#.,(2?2 (-"+4 -3 4- $7 ,$- #$ +V'8&(>-$ $3 #4 !(.38/$ &(-&(5 + 2.-3
-?"$22 (1$2/.41.!)$"3(5$1"$21?24+3 32S
- fdeeP 4-$ -.45$++$ 1$54$ 2823?, 3(04$ #$ + +(33?1 341$ \gd] 3$-3? #V?3 !+(1 4-$
1$+ 3(.-$-31$+$#?/+ "$,$-35$23(!4+ (1$#$2(-"(2(5$2, -#(!4+ (1$2$3+V // 1(3(.-#$
1?"$22(.- &(-&(5 +$ : +V (#$ #V?34#$2 $7"+42(5$,$-3 '4, (-$2S $/3 ?34#$2 .-3 ?3?
(-"+4$2S
$21?"$22(.-2&(-&(5 +$2 /1>25$23(!4+.T5$12(.-.431 -2+ 3(.-5$23(!4+ (1$#$2
(-"(2(5$2, -#(!4+ (1$2.-3?3??5 +4?$2:+V (#$#$,.4+ &$2P#$"+("'?2(-31 T.1 47P#$
3?+?1 #(.&1 /'($2#$/1.%(+$3#$+V$7 ,$-"+(-(04$#$+ &$-"(5$S4"4-$1$+ 3(.--V ?3?
,(2$ $- ?5(#$-"$ $-31$ +V //+(" 3(.- #V4- ,.45$,$-3 $- #(1$"3(.- 5$23(!4+ (1$ 4
-(5$ 4#$2(-"(2(5$2(-%?1($41$2$3+V // 1(3(.-#$1?"$22(.-2&(-&(5 +$2S
$/$-# -3P #V 431$2 % "3$412 2.-3 : ?34#($1 3$+2 04$R 4-$ % (!+$ ?/ (22$41 #$ &$-"(5$
, 1&(- +$+(!1$P4-$28,/'82$?31.(3$P4-".-31E+$(- #?04 3#$+ /+ 04$#$-3 (1$$34-
!1.22 &$#$-3 (1$ &1$22(%S
- fdegP 4-$ ?34#$ 1?31.2/$"3(5$ \ge] ,.-31? +V !2$-"$ #$ 1$+ 3(.- $-31$ +$
#?5$+.//$,$-3 #$ 1?"$22(.- / 1.#.-3 +$ $3 +$ "' -&$,$-3 #V(-"+(- (2.- #$ +V(-"(2(5$
, -#(!4+ (1$ #41 -3 +$ 31 (3$,$-3 .13'.#.-3(04$S .43$%.(2 +$2 43$412 /1?"(2$-3 04$
fl
#V 431$2?34#$22414-$/+42+.-&4$/?1(.#$$3(-"+4 -3# 5 -3 &$#$% "3$4123$+204$+
, +.""+42(.-(-(3( +$P+$!(.38/$&(-&(5 +$34-$7 ,$-"+(-(04$ 5 -3Y/$-# -3Y /1>2
31 (3$,$-3.13'.#.-3(04$2.-3-?"$22 (1$2S
-%(-P/+421?"$,,$-3$-fdeiP4-$-.45$++$?34#$#$$3 +S\gf] ?3?,$-?$$-
4104($S $-3 -$4% 24)$32 .-3 ?3? (-"+42 $3 "+ 22?2 $- %.-"3(.- #4 #?/+ "$,$-3 #$ +$41
(-"(2(5$ , -#(!4+ (1$P ?5 +4? : +V (#$ #$ 3?+?1 #(.&1 /'($2 #$ /1.%(+Q 31.(2 &1.4/$2 .-3
+.12 ?3? "1??2 R +(-&4.T5$12(.- Y /.2(3(.- 23 !+$ Y 5$23(!4+.T5$12(.-S
$2 1?"$22(.-2
&(-&(5 +$2 .-3 ?3? ?5 +4?$2 5 -3 $3 /1>2 31 (3$,$-3 .13'.#.-3(04$ 241 #$2 ,.4+ &$2
\(&41$em]S
)'52%V^ J%352%$%,!(!54%52#/2/.!)2%;,T!)$%$T5.0)%$;#/5,)33%
R$)34!.#%%.42%,%"/2$/##,53!,%4,%0/).4,%0,53!0)#!,$%,!'%.#)6%-!2').!,%S
".-"+42(.-#$"$2 13("+$2$2304V 4"4-38/$#$,.45$,$-3#$+V(-"(2(5$, -#(!4+ (1$
-V #V(-%+4$-"$241+V // 1(3(.-#$1?"$22(.-&(-&(5 +$S
($- 04V: +V'$41$ "34$++$ +$2 ?34#$2 ".-5$1&$-3 5$12 4-$ !2$-"$ #$ 1$+ 3(.-P 3.43$2
2.-34- -(,$2241+ -?"$22(3?#$2V 2241$1#$+ 2 -3?/ 1.#.-3 +$#41 -3+$31 (3$,$-3
/4(204$+V(-%+ ,, 3(.-$234-% "3$41#?"+$-"' -3#$+ 1?"$22(.-/ 1.#.-3 +$\gg]S
- $7 ,$- ,(-43($47 #$ + &$-"(5$ 5$23(!4+ (1$ #$2 (-"(2(5$2 , -#(!4+ (1$2 #.(3 @31$
1? +(2?2823?, 3(04$,$-3 5 -3#$#?"(#$1#$+ 04 -3(3?#$#?/+ "$,$-3-?"$22 (1$S
$/$-# -3P "$13 (-2 13("+$2 \gg[gk] ,$33$-3 $- ?5(#$-"$ 4-$ 1$+ 3(.- $-31$ 3.104$
\"%S
SeSeS] 1 #("4+.T5$23(!4+ (1$ $3 +V // 1(3(.- #$ #?% 432 &(-&(5 47 \(&41$ fd]S -
fdeiP4-$?34#$!1?2(+($--$\gl]1 //.13$4-" 2#$%1 "341$#$%(+#$".-3$-3(.-".++?
fm
$-31$ +V(-"(2(5$ + 3?1 +$ #1.(3$ $3 + " -(-$ #1.(3$S
$2 (-"(2(5$2 , -#(!4+ (1$2 #1.(3$2
2V?3 ($-3 +.12 +(-&4 +?$2 3 -#(2 04$ + " -(-$ & 4"'$ 2V?3 (3 5$23(!4+?$S
".-3$-3(.-
2V$23 +.12#?".++?$#$+V(-"(2(5$, -#(!4+ (1$& 4"'$04(31 5 (++ (3$-3 -304$"$-31$#$
1.3 3(.-$31$"$5 (33.43$+ "' 1&$.""+42 +$#4&4(# &$(-"(2(%#41 -3+$2,.45$,$-32
, -#(!4+ (1$2S
)'52%WUJ(/4/'2!0()%3).)4)!,%3-/.42!.4;'!5#(%,!&2!#452%$5&),$%#/.4%.4)/.%.42%YW%4
YXH%4;$2/)4%,!2>#%33)/.').')6!,%%.2%'!2$$%,!XWRX]S
)'52%WVJ).)4)!,
K).#)3)6%-!.$)"5,!)2%'!5#(%%.65%3!')44!,%3/24)%$%3!"!3%/33%53%
K65%#/2/.!,%$54)%23!0)#!,$%,!XWRX]S
$2823>,$ &?-?1?4-3.104$1 #("4+.T5$23(!4+ (1$$731@,$" 42 -3+ %$-$231 3(.-#$
3.43$ + 1 "(-$ #$ + gf )4204V: + % "$ 5$23(!4+ (1$ #$ 2.- /$7 \(&41$ fd]S
$ 3$23 #$
5(3 +(3? #$ + gf 2$ 31.45 -3 -?& 3(%P 4- 31 (3$,$-3 $-#.#.-3(04$ 3$,/.1 (1$ :
+V'8#1.78#$ #$ " +"(4, ?3? 1? +(2? $- 33$-# -3 +V /("$"3.,($ $3 +$ 1$/.2(3(.--$,$-3
.13'.#.-3(04$S
gd
-31 (3$,$-3.13'.#.-3(04$ 5$"(-".1/.1 3(.-/1.&1$22(5$#$3.104$1 #("4+.T+(-&4 +
?3?,$-?\(&41$ff]S
)'52%WWJ>#!.)15%3%'-%.4>%!6%#&),%.2%,)>;,!XW%4!58-/,!)2%3
4!.$)315%,T!2#!$%%3434!"),)3>%0!25.&),0!33)&%.!#)%2RX]S
i ,.(2P +V /$7 ?3 (3 3.3 +$,$-3 1$".45$13 #$ 3(2242 ,.42P +V /("$"3.,($ /4 @31$
1? +(2?$S eg ,.(2 #$ 31 (3$,$-3 \qe ,.(2 #$ 23 !(+(2 3(.-]P + 1 "(-$ ?3 (3 3.3 +$,$-3
1$".45$13$#$3(2242&(-&(5 47:+V$7"$/3(.-#V4-+?&$1#?% 43&(-&(5 +,(-$41$-1$& 1#
#$+ % "$5$23(!4+ (1$#$+ gf\(&41$fg]S
)'52%WX J(/4/'2!0()%3).42!L/2!,%3!6!.4R;'!5#(%S%4!02=342!)4%-%.4 R;$2/)4%SK
%5,5.$>&!54').')6!,-).%520%23)34%%.2%'!2$$%XWRX]S
V$7 ,$-3.,.&1 /'(04$,.-31$04$+ 1 "(-$ ?3?1$/.2(3(.--?$# -2+V.2 +5?.+ (1$P
!($-04V 4"4-$1?&?-?1 3(.-#$+ ".13(" +$$73$1-$-V (3?3?.!3$-4$\(&41$fh]S
ge
)'52%WYJ0/34L42!)4%-%.4$%,M).#)3)6%,!4>2!,%-!.$)"5,!)2%'!5#(%H!6%#5.%65%3!')44!,%
%4#/2/.!,%$54)%23!0)#!,-/.42!.4,T/3!5.)6%!5$%3-523,).'5!,%4->3)!,$%,!2!#).%RX]S
gf
)'52%WZJ
T!5'-%.4!4)/.$%,T%80/3)4)/.$%3).#)3)6%3-!.$)"5,!)2%3!6%#,T<'%RYUS
$+.-\emkm]PW+$1E+$#$2(-"(2(5$2, -#(!4+ (1$2# -2+V$23'?3(04$#$2/ 3($-32
#$ jd -2 $3 /+42P $23 +$ ,@,$ 04$ "$+4( #$2 (-"(2(5$2 , 7(++ (1$2 "'$9 +$2 )$4-$2 #$
,.(-2#$gd -2X\he]S
\hd] /1?".-(2$ #.-" "'$9 +$2 / 3($-32 2$-(.12 #$ ".,/+?3$1 +$ #.22($1
/'.3.&1 /'(04$ ' !(34$+ #$ #$47 /'.3.&1 /'($2R 4-$ 54$ $7.!4"" +$ $3 4-$ 54$
$-#.!4"" +$!.4"'$.45$13$P+.12#$+ /'.- 3(.-#4WX#$W,, XP$7/.2 -33.43
/ 13("4+(>1$,$-3 +$ 2$"3$41 (-"(2(% , -#(!4+ (1$ \(&41$ fj]S $2 "+("'?2 //.13$1.-3
+.124-$(-%.1, 3(.-?5(#$-3$241+$,.3(%#$".-24+3 3(.-$23'?3(04$S
)'52%W[J5%3%.$/"5##!,%3%4%8/"5##!,%3,/23$%,!0(/.!4)/.352
,%NO$%N--!OH!6!.4%4!02=3.)6%,,%-%.4/24(/$/.4)15%RYUS
$2(-"(2(5$2, -#(!4+ (1$2/1?2$-3$-3?& +$,$-34-1E+$(-#(1$"3#$2.43($-+ !( +P$++$2
(-%+4$-3241+$,.#$+?$3+ /.2(3(.-#$+ +>51$(-%?1($41$S
gg
.41
P +$ 2(++.- + !(.T,$-3.--($1 \
] $23 4- ?+?,$-3 $23'?3(04$ #.-3
+a(,/.13 -"$ $23 2.42T$23(,?$S $+.- +4(P (
(-%?1($41$.41+?$/ 1 B3
TT#(1$
/+42 (,/.13 -3 04a(+ -a$23 "+ 22(04$,$-3 #,(2] $3 2$1 (3 22$9 33(1 -3$S (2 # -2
"$13 (-$2+(,(3$2/4(204V4-241/+.,!, 104?/$43@31$+a ,.1"$#a4-$(-3$1/.2(3(.-#$
+ +>51$ (-%?1($41$S (-2(P 2$+.- "$3 43$41P (+ $23 / 1%.(2 2.4' (3 !+$ 04$ +a /$7 #$
+V(-"(2(5$ , -#(!4+ (1$ 2.(3 1$"4+? /.41
.- + !(.T
,$-3.--($1(-24%%(2 -3\fi]S
(!($-04V$-fdejP4-$?34#$#$
\hf]P,$-?$241W+$2"1(3>1$2$23'?3(04$2#$
1?422(3$ #$2 &?-(./+ 23($2XP (-2(23$ 241 +V(,/ "3 #$ + /.2(3(.- #$2 (-"(2(5$2
, -#(!4+ (1$2 241 +$ 2(++.- + !(.T,$-3.--($1 \
] \(&41$ fk]S
1? +(2 3(.- #$
2(,4+ 3(.- "?/' +.,?31(04$ \2$3T4/] /$1,$3 ?& +$,$-3 #V8 - +82$1+ /.2(3(.- (#? +$
#4,$-3.-.22$47/ 11 //.13 4!.1#+(!1$#$+V(-"(2(5$, -#(!4+ (1$S
)'52%W\J
-0!#4$%,M).#,).!)3/.$%3).#)3)6%3352,!'>.)/0,!34)%$%02/05,3)/.H
0/33)"),)4>$%#!-/5&,!'%$%,!6%34)"5,/6%23)/.$%3).#)3)6%3).&>2)%52%30!2,!
'>.)/0,!34)%-!)3%&&%4)!42/'=.%352,%
RYXS
/.2(3(.- #$ +V(-"(2(5$ , -#(!4+ (1$ $23 #.-" : (-#(5(#4 +(2$1 $- /1$- -3 $-
".-2(#?1 3(.-"$2#(%%?1$-32% "3$412S
gh
KXK002/#(%#>0(!,/->42)15%
$2 ,.8$-2 #V?5 +4 3(.- #$ "$33$ /.2(3(.- [ .431$ +V$7 ,$- "+(-(04$ [ 2.-3 +$2
#(%%?1$-3$2 - +82$2"?/' +.,?31(04$2\(&41$fl]S
)'52%W]J).1%8%-0,%3$%$>4%2-).!4)/.$%,!0/3)4)/.$%,M).#)3)6%-!.$)"5,!)2%
3%,/.,%3!.!,93%3#>0(!,/->42)15%354),)3>%3RYYSJ
)*! '&)*!
&)*!
&)*!"(
&)*!"#
--.3$4-$#(5$12(3?#$/.2(3(.-(#? +$#$+V(-"(2(5$, -#(!4+ (1$2$+.-+$2 43$412P$++$
2$1 #.-" 22$95 1( !+$P/+42.4,.(-25$23(!4+?$$-%.-"3(.-#$+V - +82$1? +(2?$S
gi
$ /1$,($1P (+ /$-2? : 5(24 +(2$1 + /.2(3(.- #$ +V(-"(2(5$ , -#(!4+ (1$ $- %(- #$
31 (3$,$-3 04( ?3 (3 2.- /1(-"(/ + .!)$"3(%S
+ 31 "$ 241 4- %(+, 4- 31( -&+$ %.1,? / 1 +$
/+ - #$ 1 -"%.13P +$ /+ - , -#(!4+ (1$ #$ .6-2 \3 -&$-3$ 4 !.1# (-%?1($41 #$ +
, -#(!4+$] $3 +a 7$ #$ +a(-"(2(5$ (-%?1($41$ \(&41$ fm]S
$2 31.(2 -&+$2 #$ "$ 31( -&+$
2.-3R\hj]
- \""$
%" ]R $-31$ +$ /+ - #$ 1 -"%.13 $3 +$ /+ -
, -#(!4+ (1$Q
-
\""$
%"#"]R$-31$+V 7$#$+V(-"(2(5$, -#(!4+ (1$
$3+$/+ -#$1 -"%.13Q
-
\#"
%"
] R $-31$ +$ /+ - , -#(!4+ (1$ $3 +V 7$ #$
+V(-"(2(5$, -#(!4+ (1$S
)'52%W^J2)!.',%&!#)!,$%7%%$RY\S
$2 ,$241$2 "?/' +.,?31(04$2 2.-3 $-24(3$ $%%$"34?$2 $3 ".,/ 1?$2 : #$2 -.1,$2
?3 !+($2 / 1 P 2$+.- #$2 ?"' -3(++.-2 #$ / 3($-32 2?+$"3(.--?2 /.41 +$41
".-%.1,(3?:2.-(#? +$23'?3(04$P:2 5.(14-W/1.%(+/+ 3 4,$-3.-/1.?,(-$-3X\hi]S
V -&+$
P#?%(-(22 -3+V.1($-3 3(.-#$+V 7$#$+V(-"(2(5$, -#(!4+ (1$/ 11 //.13:
2.- .2 ! 2 +P #.(3 3$-#1$ 5$12 4-$ -.1,$ #$ lkuS
5 +$41 ./3(, +$ #$ +V -&+$
5 1($$-%.-"3(.-#$+ 5 +$41#$+V -&+$\$-+($- 5$"+$2$-25$13(" +/ 1#(5$1&$-"$
% "( +$]P#.-3+ 5 +$41$23-.-,.#(%( !+$R
gj
- fdussfluR" 2-.1,.#(5$1&$-3P+a -&+$04$%.1,$+a(-"(2(5$(-%?1($41$ 5$"
+$/+ -#$1 -"%.13\
]#.(3@31$#$jluQ
- t fluR " 2 '8/$1#(5$1&$-3P +a -&+$ 04$ %.1,$ +a(-"(2(5$ (-%?1($41$ 5$" +$
/+ -#$1 -"%.13\
]#.(3@31$#$jiuQ
- s fduR " 2 '8/.#(5$1&$-3P +$ #?" + &$ 2 &(33 + $23 %1?04$,,$-3 % (!+$P
+V?5 +4 3(.- #$ + /.2(3(.- #$ +V(-"(2(5$ , -#(!4+ (1$ / 1 1 //.13 4 1$23$ #$ +
% "$ /$1# #$ 2.- (-3?1@3S
V -&+$
$23 +.12 +V -&+$ #$ 1?%?1$-"$P (+ -$ #.(3
"$/$-# -3 / 2 $7"?#$1 mfu /.41 #$2 1 (2.-2 #$ 23 !(+(3? #$ +V(-"(2(5$ (-%?1($41$
\hi]\(&41$gd]S
)'52%XUJ/2-5,%$%RX]S
31 "$ +.12 $- /.(-3(++?2 4- -.45$+ 7$ (-"(2(% / 22 -3 / 1 +a /$7 #$ +a(-"(2(5$
(-%?1($41$\+$,.45$,$-3#$+a(-"(2(5$2$% (3 5$"4-"$-31$#$1.3 3(.- 4-(5$ 4#$2.-
/$7]$3%.1,$ 5$"+$/+ -#$1 -"%.134- -&+$#a 4,.(-2jiuS
(-2( 2$ 5(24 +(2$ + /+ "$ 2.4' (3?$ #$ +a(-"(2(5$ $- %(- #$ 31 (3$,$-3P +a(,/.13 -"$ #4
,.45$,$-3 : 1? +(2$1 : / 13(1 #$ +a 7$ #$ #?!43 #$ 31 (3$,$-3S
".11$"3(.-
"?/' +.,?31(04$: //.13$1 4-(5$ 4#$+V(-"(2(5$, -#(!4+ (1$P$-+ 1$"4+ -3$3$-+
5$12 -3+(-&4 +$,$-3P$-31$# -2+V?5 +4 3(.-#$+ #82' 1,.-($3.3 +$S' 04$#$&1?#$
5$12(.-+(-&4 +$".-2.,,$$-5(1.-dPl,,#V$2/ "$241+V 1" #$S
//+(04? 231("3$,$-3P +$ 1$/.2(3(.--$,$-3 (-"(2(% ".-#4(3 31>2 %1?04$,,$-3 : #$2
$731 "3(.-2#$/1?,.+ (1$2S4).41#V'4(P".-2(#?1 -304$"$2$731 "3(.-21(204$1 ($-3#$
".-#4(1$ : 4- /1.%(+ 31./ 1?3142(% $- %(- #$ 31 (3$,$-3P #$2 ".,/1.,(2 241 +$
1$/.2(3(.--$,$-3#$+V(-"(2(5$2.-32.45$-3+ 1>&+$S
gk
(-2(P +$ W6$$#(23$X "34$+P 2$ %." +(2$ ,.(-2 241 + /.2(3(.- 3'?.1(04$ #$ +a(-"(2(5$
(-%?1($41$ 04$ 241 +a?04(+(!1$ %.-"3(.--$+ #$2 1" #$2 $-31$T$++$2 # -2 4- ".-3$73$
#a' 1,.-($% "( +$S
$ ".-"$/3 #V' 1,.-($ % "( +$ #?"1(3 / 1
$- emjj \hlPhm]P $23 ?5 +4? / 1
+V -&+$%.1,?$-31$+ +(&-$$23'?3(04$\).(&- -3+$/.&.-(.-"43 -?:+ +>51$+ /+42
/1.3142(5$]$3+$/+ -#$1 -"%.13\(&41$ge]S
)'52%XV J !2-/.)%&!#)!,%$>&).)%0!2,M!.',%&/2->%.42%,!,)'.%%4,%0,!.$%2!.#&/24 RYZS
+(&-$?5.+4$$-1 //.13 5$"+V 7$#$+V(-"(2(5$(-%?1($41$S 5 +$41,.8$--$$23#$
klu/.414- -&+$
#$jiuS
.1204$+ +(&-$$233 -&$-3$:+ +>51$(-%?1($41$P2(
+V(-"(2(5$(-%?1($41$-$24!(3/ 2#$#?/+ "$,$-3P+ 5 +$41#$+V -&+$-$"' -&$1 / 2S
1".-31$P2("$33$+(&-$$233 -&$-3$:+ +>51$24/?1($41$P+V -&+$2V ,?+(.1$1 5$"
+ 1?#4"3(.-#$+V -&+$S
V' 1,.-($#4/1.%(+1$/.2$?& +$,$-3241+ ,$241$#$+V?/ (22$41#$23(2242,.42
\(&41$gf]R
- W//$1+(/3'("*-$22X\
]R?/ (22$41,$241?$$-31$+ % "$5$23(!4+ (1$#$
+V(-"(2(5$"$-31 +$, 7(++ (1$$3+$/.(-3+$/+42/1.?,(-$-3#$+ +>51$24/?1($41$Q
- W.3 +"'(-3'("*-$22X\]R?/ (22$41,$241?$$-31$+ +(&-$$3+$/.&.-(.-
"43 -?S
gl
)'52%XWJ00%2,)0%44/4!,#().RY]S
V' 1,.-($#$+ 1?/ 13(3(.-#$23(2242,.42$23 +.12?5 +4?$$-" +"4+ -3T
R
(T
tdR/1.%(+' 1,.-($47
(T
sdR#82' 1,.-($ #$2 3(2242 ,.42P 4-$ ".,/$-2 3(.- / 1 1$/.2(3(.-T
-$,$-3 #$2 (-"(2(5$2 (-%?1($41$2 $23 -?"$22 (1$ %(- #$ 1?3 !+(1 +V?04(+(!1$ #$
+V?3 &$(-%?1($41#$+ % "$S
V /1>2
P+ /.2(3(.-#$+V(-"(2(5$, -#(!4+ (1$#?/$-##4/+ - 2(.-T.(-3
\]$3$23#?3$1,(-?$/ 14-$,$241$,(++(,?31(04$$34-$,$241$ -&4+ (1$S
5$"+$W ,(-(,4,5(3 + XP(+ (-31.#4(32.- - +82$$-emig $3 + /1?"(2$$-emim$-
//.13 -3+$2#.--?$2#$2.-$7/?1($-"$ %(-#V$-% "(+(3$1+V43(+(2 3(.-\idPie]S
+ ?3? +$ /1$,($1 : 24&&?1$1 04$ +$2 ,$241$2 (-#(5(#4$++$2 4 -(5$ 4 204$+$33(04$P
#$-3 (1$$3#$23(2242"43 -?2P/4(22$-3@31$(-3$1#?/$-# -3$2S
V - +82$#$3$(-$1$23
4-$ - +82$ 2 &(33 +$ 04( /1."41$ 4-$ !.--$ 5(24 +(2 3(.- #$ + /.2(3(.- #$2 (-"(2(5$2
, -#(!4+ (1$2P/$1,$33 -3:+ %.(24-$,$241$ -&4+ (1$$34-$,$241$+(-? (1$1$+ 3(5$
4/+ - 2(.-T.(-3S
gm
.41"' 04$/ 3($-3P /1>2 5.(1?3 !+(4-!(+ -#$-3.T204$+$33(04$P(+ - +82$+ /.2(3(.-
#$+V(-"(2(5$, -#(!4+ (1$:/ 13(1#$,$241$2"?/' +.,?31(04$23$++$204$R
) 4/ R./2-!,)4>J Y --S J#(23 -"$$-31$+$/.(-3+$/+42 -3?1($41#$+ % "$
5$23(!4+ (1$#$2(-"(2(5$2"$-31 +$2, -#(!4+ (1$2$3+ +(&-$ 2(.-T.(-3\]S
\ie] \(&41$ gg]S
$2 5 +$412 ,.8$--$2 .!2$15?$2 / 1 #V 431$2 43$412 -$
#(%%>1$-3 04$ 1$+ 3(5$,$-3 /$4 $3 2$ 1 //1."'$-3 #$ + 5 +$41 #$ h ,, #.--?$
/ 1
\if]S
$
1"*2
$
12
)'52%XXJ.%6!,%52$%)4/350>2)%52%;Y-->6/15%5.%02/L!,6>/,)%$%,M).#)3)6%
-!.$)"5,!)2%H5.%6!,%52$%)4/350>2)%52%;WZg>6/15%5.%6%34)"5,/L6%23)/.$%
,M).#)3)6%-!.$)"5,!)2%
) 4/ R./2-!,)4>J WZgcPL YgSR -&+$ $-31$ +V 7$ +.-&(34#(- + #$2 (-"(2(5$2
, -#(!4+ (1$2 $3 + +(&-$ 2(.-T.(-3 \] \ig]S
$2 5 +$412 ,.8$--$2
.!2$15?$2/ 1#V 431$2 43$4125 1($-3#$fd:flu\(&41$gg]S
/'/.)/. 4/ R#(23 -"$$-31$+$/.&.-(.-$3+ +(&-$\(&41$gh]S
+-V8
/ 2#$5 +$41(#? +$$-1 (2.-#$2 &1 -#$5 1( !(+(3?S.43$%.(2P
"'.(2(3
#V //+(04$1 + 1>&+$ #V
04(P $- emlh \ih]P?5.04$ 4-$ 1$+ 3(.-
2(&-(%(" 3(5$ $-31$ + #(23 -"$ 04( 2?/ 1$ +V(-"(2(5$ , -#(!4+ (1$ $3 +$ /.&.-(.-
hd
.22$47#$+ +(&-$ T.(-3S$2,$241$2#$5 -3@31$?& +$23.43$- #,$33 -3
4-$ #(%%?1$-"$ #$ f,, 2( +$2 3(2242 #$ 1$".451$,$-3 .-3 4-$ ?/ (22$41
,.8$--$R(3.r.&3.qYTf,,S
)'52%XYJ
!2=',%$M
RZYS
$ !.-1 //.13".-#(3(.--$+ 23 !(+(3?#$+a(-"(2(5$(-%?1($41$# -22 ! 2$.22$42$$3$-
,@,$3$,/24-/1.%(+' 1,.-($47S(+ #(%%?1$-"$$-31$+$2#$475 +$412$2324/?1($41$
: h ,, 4 /1.%(3 #$ +V(-"(2(5$P (+ % 43 + 1$#1$22$1 /.41 ,?+(.1$1 +$ /1.%(+S $/$-# -3P
/.414-$28,/'82$ 5$"4-%.13/.&.-(.-P"$33$5 +$41$23/ 1%.(2$7"$22(5$/.41@31$
/1(2$$-1?%?1$-"$Q(+$-$23#$,@,$/.41+ 2(34 3(.-.//.2?$\fh]S
%(- #V?5 +4$1 +V.1& -(2 3(.- (#? +$ #$2 (-"(2(5$2 $- /1$- -3 $- ".,/3$ +$ #?" + &$
2 &(33 +#$2! 2$2.22$42$2P
,(2$-/+ "$4-".-"$/3(-3(34+?RW+$2".,/1.,(2
""$/3 !+$2XS
412 "' 13$\(&41$gl]P(+#$22(-$4-$2?1($#$"'$51.-25(#$22"'?, 3(2 -3+$2 7$2
#$2(-"(2(5$224/?1($41$$3(-%?1($41$$-.""+42(.-$-54$+ 3?1 +$\(&41$gi]S
he
)'52%XZJ
%#(%62/.$%
.41"' 04$/ 3($-3P(+/.2$ +.124-"'$51.-/1.!+>,$#.-3+$25 +$4122.-3(224$2#$
2.- - +82$ "?/' +.,?31(04$S
+ #?%(-(3 4- "'$51.- P +$ 2?+$"3(.-- -3 # -2 2 +(23$
/1?#?%(-($W#V 11 -&$,$-32 ""$/3 !+$2X2$+.-+ 5 +$41#$+V -&+$#4/ 3($-3P$-
$23(, -304$"$+4(T"(/$43@31$1?#4(3#V4-/$4,.(-2#$+ ,.(3(? 5$"+ 3'?1 /$43(04$S
- 431$ "'$51.- ?34#($ + /.2(3(.- #$ +V(-"(2(5$ , -#(!4+ (1$ 3'?.1(04$ 2$+.- + 1>&+$
#V
$-/1$- -3$-".,/3$4-$ 4&,$-3 3(.-#$+ #(23 -"$#4.&3.#$
dPi,,/ 1 - 5$"+ "1.(22 -"$\# -2+$" #1$#V4-31 (3$,$-3.13'.#.-3(04$#41 -3
f -2 (+ ).43$ &?-?1 +$,$-3 qe,,]S
+ #?3$1,(-$ +.12 4- "'$51.- 1?2.+4 04( $23 4-$
,.8$--$ #$2 "'$51.-2 $3 .&.-(.- /1?"?#$-32P (+ +V(-#(5(#4 +(2$ / 1 + 24(3$ $-
?34#( -3+ #82' 1,.-($#$-3.T, 7(++ (1$\]#4/ 3($-3S
#82' 1,.-($ #$-3.T, 7(++ (1$ $23 #?%(-($ : + , -#(!4+$ / 1 31.(2 / 1 ,>31$2 R
+V$-".,!1$,$-3#$-3 (1$P+$1$/.2(3(.--$,$-3(-"(2(%$3+$-(5$++$,$-3#$+ ".41!$#$
/$$S
!,%52 $% ,T%.#/-"2%-%.4 $%.4!)2%\(&41$ gj] J "V$23 + #(%%?1$-"$ $-31$
+a$2/ "$#(2/.-(!+$$3+a$2/ "$-?"$22 (1$PW#(2"1$/ -"8X/.41+$2 -&+.T2 7.-2S
++$$23" +"4+?$:+V (#$#$+V(-#("$#$ -"$3$+04$R$-".,!1$,$-3r[S
- \$2/ "$ #(2/.-(!+$] R#?%(-( :+V (#$#V4-%(+#$+ (3.-).(&- -3+$2% "$2
,?2( +$2 #$2 /1$,(>1$ ,.+ (1$2 /$1, -$-3$2 #1.(3$ $3 & 4"'$ $-
/ 1".41 -3+$/?1(,>31$#V 1" #$S
hf
- \$2/ "$ -?"$22 (1$]R ,$241$ #$2 #(,$-2(.-2 ,?2(.#(23 +$2 #$2 #$-32
2(34?$2 ,?2( +$,$-3 / 1 1 //.13 47 /1$,(>1$2 ,.+ (1$2 /$1, -$-3$2
\(&41$gj]S
)fR/ 1#?% 43\#$-32/+42/$3(3$204$+ ,.8$--$2414-, 7(++ (1$
#$5.+4,$' !(34$+.4,("1.#.-3($]P.!)$"3(5?$"+(-(04$,$-3/ 1+ /1?2$-"$#$
#( 23>,$2S
) f R / 1 $7">2 \#$-32 /+42 (,/.13 -3$2 04$ + ,.8$--$ 241 4-
, 7(++ (1$ #$ 5.+4,$ ' !(34$+ .4 , "1.#.-3($]P .!)$"3(5?$ "+(-(04$,$-3 / 1 4-
$-".,!1$,$-3\ii]S
)'52%X[J%352%$%,T%30!#%$)30/.)",%RS;'!5#(%%4$%,M%30!#%.>#%33!)2%RS;$2/)4%K
%2%0/3)4)/..%-%.4).#)3)&J(+".11$2/.-#:+ 04 -3(3? -&4+ (1$#$5$12(.-#$
+V(-"(2(5$ , -#(!4+ (1$ $%%$"34?$ +.12 #4 31 (3$,$-3Q 4-$ 5$23(!4+.T5$12(.- #$
+V(-"(2(5$ 4&,$-3$+V$2/ "$3 -#(204V4-$+(-&4.T5$12(.-#(,(-4$"$3$2/ "$S
5 +$41$-,(++(,>31$$23.!3$-4$:/ 13(1#4W"'$51.-1?2.+4XR+ 5 +$41#$(3.
#4"'$51.-W1?2.+4X$232.4231 (3$:"$++$#4"'$51.-W(-(3( +XS$1?24+3 3
$23,4+3(/+(?/ 1#$47/.41(-"+41$# -2+$"
(-2(P "' 04$ ,(++(,>31$ #$ 1$"4+ .4 #V 5 -"?$ #$2 (-"(2(5$2 , -#(!4+ (1$2
1 "".41"(3.4 ++.-&$+V 1" #$#$f,,S
)6%,,%-%.4$%,!#/52"%$%0%%J+ ,.#(%(" 3(.-#$+ +.-&4$41#a 1" #$P+(?$
4 -(5$++$,$-3 #$ + ".41!$ #$ /$$P $23 + /1$,(>1$ ?3 /$ 3'?1 /$43(04$ $-
3$"'-(04$#&$6(2$S
V ++.-&$,$-3#4/?1(,>31$#V 1" #$\ij]P".11$2/.-# -3:
hg
4-$/$13$#$".-31E+$ 4-(5$ 4#$+ /.2(3(.-#$+a(-"(2(5$, -#(!4+ (1$+.12#$
+ ,(2$:/+ 3#$+ ".41!$#$/$$P$23?5 +4?/ 1#(%%?1$-32(-#("$2\(-#("$2#$
P
P$-31$ 431$2]S
.$)#%$%
\ij]R#dUHY]]RcSQUHZV
#R/?1(,>31$#a 1" #$W".-2.,,?X/ 1+$-(5$++$,$-3
c R 2.,,$ #$2 ,$241$2 #$ /+42 &1 -# ?" 13 #1.(3 $3 & 4"'$ $-31$ 4- /+ - #1.(3
//+(04?241+V 1" #$$3+$2/.(-3$2"42/(#($--$2#$2#$-32\/1.%.-#$41#$+ ".41!$#$
/$$]\(&41$gk]S
)'52%X\J2/&/.$%52$%,!#/52"%$%0%%RZZS
.$)#%$%
\ik]R#dWPXRcScV
$3(-#("$$2343(+(2?+.1204$+$2".41!$2#$/$$2.-3, 104?$2S
.$)#%$%,!&/.$!4)/.\ik]P/+422(,/+$:43(+(2$1R#dbRcScV
$3 ++.-&$,$-3$23 +.12#?#4(3#$+V$2/ "$#(2/.-(!+$S431$,$-3#(3P+$-(5$++$,$-3#$
+ ".41!$#$/$$31 #4(33.4).4124-$/$13$#V$2/ "$\il]S
$2 31.(2 5 +$412 2.-3 $-24(3$ 1$/.13?$2 # -2 + !.B3$ #$
$3 %.41-(22$-3P / 1
2(,/+$ ##(3(.-P+ 5 +$41$-,(++(,>31$2#$+ #82' 1,.-($#$-3.T, 7(++ (1$S-$5 +$41
/.2(3(5$ $23 1 1$P $++$ /$43 @31$ +(?$ : #$2 #( 23>,$2 .4 : 4-$ 5$12(.- ".1.-.T+(-&4 +$
(-(3( +$#$2(-"(2(5$2, -#(!4+ (1$2S
.1204$ + #82' 1,.-($ #$-3.T, 7(++ (1$ $23 +?&>1$P (+ $23 234"($47 #$ 1$"'$1"'$1 4-
".,/1.,(2 / 1 5$23(!4+.T5$12(.- #$ +V(-"(2(5$ , -#(!4+ (1$P # -2 +$2 +(,(3$2
hh
""$/3 !+$2S - /$43 +.12 #?3$1,(-$1 +$2 5 +$412 #4 "'$51.- W(-#(5(#4 +(2?X
".11$2/.-# -3 47.!)$"3(%23'?1 /$43(04$2\(&41$gl]S
)'52%X]J(!24%$%
!24)%350>2)%52%J#(%62/.3)$>!58RN#/-02/-)3!##%04!",%3OS3%,/.,M!.',%
!24)%).&>2)%52%J,%3$)&&>2%.43#(%62/.3%4,%5232>&,%8)/.3K
- emkiP
"(3? / 1
\hh]P ,(2 $- ?5(#$-"$ 4- 431$ / 1 ,>31$ #$
23 !(+(3?P : 2 5.(1 + 1$+ 3(.- $-31$ +V 7$ #$ +V(-"(2(5$ , -#(!4+ (1$ $3 +$ /+ - T.& #$
\im] $- /1?T31 (3$,$-3 \(&41$ gm]S
/.2(3(.- #$ +V(-"(2(5$ , -#(!4+ (1$
#?/$-# +.12#V4-/+ -#$-3 (1$$3-$% (3/+421?%?1$-"$:#$2/.(-32"1;-($-2 \jd]S
hi
)'52%X^J,!.$%.4!)2%L/'
-2 2.- ?34#$ \je]P (+ -.3? 04$ +.1204$ +$2 (-"(2(5$2 , -#(!4+ (1$2 2$ 31.45 ($-3
(-(3( +$,$-3 $- 11(>1$ #4 /+ - T.&P +$41 /.2(3(.- 5 (3 /4 @31$ 5 -"?$ 2 -2 5.(1
// 1 B31$ #$ 1?"(#(5$S 422(P (+ #?,.-31? 04$ + 1$+ 3(.- $-31$ "$ /+ - ".,/.2? #$2
/.(-32 $3 .& \+(,(3$2 -3?1($41$2 "?/' +.,?31(04$2 #$ +V.2 ! 2 + , 7(++ (1$ $3
, -#(!4+ (1$] $3 +V(-"+(- (2.- #$ +V(-"(2(5$ , -#(!4+ (1$ -$ 2$ 31.45$ 04$ 31>2 /$4
,.#(%(?$#41 -3+ "1.(22 -"$S
$4+ +$ / 22 &$ #$ + #$-341$ 3$,/.1 (1$ : + #$-341$ #?%(-(3(5$ /$43 $-31 (-$1 4-$
+?&>1$5 1( 3(.- 5$"4-$ 5 -"?$#$2(-"(2(5$2, -#(!4+ (1$2#$f,,$- 5 -3#$+
+(&-$T.&P 5$"4-?" 1338/$#$f,,S
(-2(P # -2 2.- - +82$P
,$241$ + /.2(3(.- #$ +V(-"(2(5$ , -#(!4+ (1$ / 1
1 //.13:+ +(&-$T.&$-#(23 -"$$3$- -&4+ 3(.-\jfPjg]\(&41$hd]S
V /1>2 4-$ ?34#$ ,$-?$ 241 eddd " 2 \jh]P (+ ,.-31? 04$ +V -&4+ 3(.- #$ +V 7$ #$2
(-"(2(5$2"$-31 +$2, -#(!4+ (1$2 5$"+ #1.(3$.(-3T.& 4-$5 +$41#$fdPiuqYTedS
.3.-2 04$ "$3 -&+$ $23 ?& +$,$-3 $,/+.8? / 1
\emif] $3 / 1
\emjd]S
$!.1#+(!1$#$2(-"(2(5$2"$-31 +$2, -#(!4+ (1$2#.(32$/1.)$3$1241+ +(&-$
T.&.4:04$+04$2,(++(,>31$2$- 5 -3#$"$33$+(&-$\dPi,,qYTi]\ji]S
hj
)'52%YUJ/3)4)/.$%,T).#)3)6%-!.$)"5,!)2%3%,/.
R[[S
+ - +82$ ?& +$,$-3 + /.2(3(.- 5$13(" +$ #$ +V(-"(2(5$ / 1 1 //.13 4 /+ - #V.""+42(.-
\]R+$!.1#+(!1$#.(3@31$e,, 4T#$2242#4S
II.3.4. Discussion
- emljP
$3 \jk] .!2$15$-3 04$P /.41 4-$ /.2(3(.- -.1, +$ #$ +
, -#(!4+$P+$2 -&+$2$3+$2,$241$2+(-? (1$2/$1,$33$-3#$#?3$1,(-$1#$% =.-%( !+$
+ /.2(3(.-#$+V(-"(2(5$, -#(!4+ (1$S$/$-# -3P(+2-.3$-3?& +$,$-304$+V -&+$
[ #?3$1,(-? / 1 [ .4 + #(23 -"$ T.& [ ?5.04?$ / 1
[ 2.-3
&1 -#$,$-3 #?/$-# -32 #$ +V.1($-3 3(.- #$ + , -#(!4+$ \(&41$ heP (&41$ hf]S $33$
#$1-(>1$#.(3#.-"@31$/1(2$$-".-2(#?1 3(.-S
hk
)'52%YVJ
.&,5%.#%$M5.%02/-!8),,)%/5$M5.%2>42/-!.$)"5,)%352,%3-%352%3;0!24)2
$50,!.L/'J,!02/-!8),,)%$)-).5%,%36!,%5234!.$)315%,!2>42/-!.$)"5,)%/5
,M/56%2452%$%,M!.',%-!.$)"5,!)2%,%3!5'-%.4%.4
)'52%YWJ
M!.',%
>4!.4%.4)=2%-%.4#/.&).>;,M).4>2)%52$%,!
-!.$)"5,%.M%34H,5)H0!3!&&%#4>0!2,%3#(!.'%-%.43315%,%44)15%3
$ /+42P (+2 -.3$-3 04$ + /.2(3(.- #4 /.(-3 $23 22$9 % "(+$,$-3 (-%+4$-"?$ / 1 +
3'?1 /$43(04$.13'.#.-3(04$S
.43$%.(2P
\emlj]\jl]".-2(#>1$".,,$4- 5 -3 &$04$+$/+ -T.&2.(3
$-1$+ 3(.-?31.(3$ 5$"+$22314"341$2.22$42$204((-%+4$-"$-3+ /.2(3(.-#$2(-"(2(5$2
, -#(!4+ (1$2S(-2(P.-/$43.!2$15$1#$% =.-/1?"(2$+$2$%%$32#$+ "1.(22 -"$$3#$
+ 3'?1 /$43(04$S
hl
1 (++$412P + ! 2$ ".-"$/34$++$ #$ "$2 - +82$2 1$/.2$ 241 +$ /.234+ 3 24(5 -3 R $23
#?2(1 !+$/.414-(-#(5(#4"$04($2323 3(23(04$,$-3W,.8$-XS$/1(-"(/$2$,!+$31>2
#(2"43 !+$P +
T ,?1(" (-]S (2 (+ -a$23 / 2
#?,.-31? 04a(+ 2.(3 2.4' (3 !+$ /.41 "$3 (-#(5(#4 04$ 2$2 #$-32 #./3$-3 +a.1($-3 3(.-
,.8$--$#$+a?"' -3(++.-\fi]S
(5$12$2/ 13("4+ 1(3?2/'82(.+.&(04$2.4 - 3.,(04$2/$45$-32a8.//.2$1SV.F"$33$
"(3 3(.- #$ R W
$2 ,.8$--$2 43(+(2?$2 $- "?/' +.,?31($ #$51 ($-3 @31$
?3 !+($2 / 1 1 //.13 47 5 1( !+$2 24(5 -3$2 R ;&$P 2$7$P 1 "$P .1(&(-$ $3'-(04$ $3
".-23(343(.-P $3 ,@,$ 38/$ % "( + XS .42 /.411(.-2 ?& +$,$-3 8 ).43$1 #$2
" 1 "3?1(23(04$2$23'?3(04$2$3-$41./'82(.+.&(04$2S
.41 ".-"+41$P (+ -V$7(23$ / 2 #$ 1>&+$ 4-(5$12$++$ 04( /4(22$ #?3$1,(-$1 + /.2(3(.-
(#? +$#$+V(-"(2(5$, -#(!4+ (1$".,,$$-3?,.(&-$+$204$+04$2$7$,/+$2#.--?2/ 1
+$2 - +82$2"?/' +.,?31(04$2+$2/+42".41 ,,$-343(+(2?$2S$2,$241$21?24+3$-3#$
,.8$--$2 04( ".11$2/.-#$-3 : #$2 .!)$"3(%2 3'?1 /$43(04$2R "$13 (-2 /1(5(+?&($-3 +
23 !(+(3?P#a 431$2+V$23'?3(04$S
+2V &(1 #.-"#$"'.(2(1+$,$(++$41".,/1.,(2S
.41
P2(+V.13'.#.-3(23$#.(32$31.,/$1241+ /.2(3(.-#$2(-"(2(5$2(-%?1($41$2P
(+ 5 43 ,($47 +$ % (1$ $- % 5$41 #4 "E3? +(-&4 +S $+.- +4(P +$2 (-"(2(5$2 , -#(!4+ (1$2
/+ "?$2 31./ 5$23(!4+ (1$,$-3 2$1.-3 1$/.422?$2 +(-&4 +$,$-3 / 1 +$2 /1$22(.-2
,42"4+ (1$2#$2+>51$2S
4).41#V'4(P +$2 .13'.#.-3(23$2 (-2(23$-3 #$ /+42 $- /+42 241 +$2 $7(&$-"$2 $23'?3(04$2
2 -2 5.4+.(1 /.41 43 -3 % (1$ !231 "3(.- 47 "1(3>1$2 #$ 23 !(+(3?S 422(P 2$+.-
$3
\jm]P+V(-"(2(5$, -#(!4+ (1$#.(3@31$1$/.2(3(.--?$$-%.-"3(.-
#$ +V - +82$ "+(-(04$ #4 / 3($-3 /+43E3 04$ 2$+.- +V - +82$ "?/' +.,?31(04$S
".-"$/3(.-#$P2$+.-+ 04$++$+$2(-"(2(5$2(-%?1($41$2#.(5$-3@31$3.4).412/+42
.4,.(-2/$1/$-#("4+ (1$2:+V.2! 2 +P2$,!+$.!2.+>3$\jj]S
+42 1?"$,,$-3P # -2 4- ,.45$,$-3 #$ ! + -"($1 22$9 ' !(34$+ $- ,?#$"(-$P +$2
1?/$1"422(.-2 $23'?3(04$2 / 1%.(2 , +'$41$42$2 #$2 $731 "3(.-2 241 #$2 /1.%(+2
hm
"(2%1.-3 47.4/.41542#$+>51$2%(-$2.-3".-#4(32#$2 43$412".,,$\kd]P:
#(,(-4$1 %.13$,$-3 +$2 (-#(" 3(.-2 #V$731 "3(.-P ,@,$ # -2 #$2 " 2 #$ %.132
$-".,!1$,$-32P 47#?/$-#2#4".-31E+$#$+ /.2(3(.-#$+V(-"(2(5$, -#(!4+ (1$S
.42 #$5.-2 1$".-- B31$ 04$ +$2 %.-#$,$-32 2"($-3(%(04$2 #$ "' "4-$ #$ "$2
W/'(+.2./'($2 #$ 31 (3$,$-3 X 2$,!+$-3 !($- % (!+$2 : +V 4-$ #$2 "1(3>1$2 "34$+2 #$ +
,?#$"(-$%.-#?$241+ /1$45$.4W$5(#$-"$! 2$#,$#("(-$XS
id
M
0##$"$$### "
##'$"$0
ie
J
%#/.42@,%$%,!0/3)4)/.
$%,M).#)3)6%-!.$)"5,!)2%
V //+(" 3(.- #$ 31 "3(.-2 (-3$1, 7(++ (1$2 \
] #$ "+ 22$
\"%S
]S $/$-# -3P +$2 1?/$1"422(.-2 , -#(!4+ (1$2
-3?1($41$2 5$23(!4+ -3$2 #$ "$33$ %.1"$ #.(5$-3 @31$ %1$(-?$2 %(- #$ , (-3$-(1 +$2
(-"(2(5$2 , -#(!4+ (1$2 # -2 4-$ /.2(3(.- (#? +$ \!($- 04$ 5 1( !+$ 2$+.- +$2 43$412]
1?/.-# -3 47.!)$"3(%2#$23 !(+(3?$3#V$23'?3(04$S
.42 ++.-2 #.-" -.42 (-3?1$22$1 47 #(%%?1$-32 ,.8$-2 #V -"1 &$ : -.31$ #(2/.2(3(.-
/.41".-31E+$1+ /.2(3(.-#$+V(-"(2(5$, -#(!4+ (1$#41 -3+$31 (3$,$-3#$+ "+ 22$
/ 1
S
III.1.1.1. Définition
$+.- + ."(?3? 1 -= (2$ #V13'./?#($ $-3.T "( +$ \] \kf]P +$ 3.104$ #?2(&-$
W+ 3.12(.-#$+V 1"241+$"' -3\".41!41$#$g>,$.1#1$]$3P/ 1$73$-2(.-P+V.1($-3 3(.-
#$+ &.1&$#$+V 33 "'$#$23(-?$:(-"+(-$1+ #$-3# -2+$2$-25$23(!4+.T+(-&4 +/ 1+$
#?/+ "$,$-3#$+V /$7S
$3.104$$234-$ "3(.-P+V(-"+(- (2.-$232.-$%%$3S
$,.33.104$
2V //+(04$:+V &$-3,?" -(04$P+$,.35$12(.-:+ #$-3XS
if
$3.104$$23#(3/ 22(%2(+a 1"2V$-& &$# -2+V 33 "'$2 -2$%%$3#$3.12(.-P(+$23#(3 "3(%
# -2+$" 2".-31 (1$\(&41$hg]S
)'52%YXJ
,,5342!4)/.$54/215%!#4)&%40!33)&
III.1.1.2. Intérêts
/ 1
P+V$%%$3#$5$23(!4+.T5$12(.-(-"(2(5$, -#(!4+ (1$/.411 @31$(-'(!?$/ 1+
+$"341$#V4-3.104$".1.-.T+(-&4 +# -2"$2$"3$41P04$+V(-%.1, 3(.- (3?3?(-".1/.1?$
# -2+V 1"\".41!41$#$g>,$.1#1$].4/1?T(-%.1,?$# -2+$25$11.42S
a$7/1$22(.- #4 3.104$ /$43 @31$ 1? +(2?$ $- 1$,/+(22 -3 + &.1&$ #4 5$11.4 / 1 4-$
4&,$-3 3(.- /1.&1$22(5$ #$ + 2$"3(.- #$2 1"2 4 ".412 #4 31 (3$,$-3P #(,(-4 -3 +$
W)$4&?.,?31(04$X$-31$+$5$11.4$3+V 1"\kg]S (2+ 2$"3(.-#4#$1-($1 1"#$31 5 (+
-a 33$(-3 ) , (2 3.43 : % (3 "$++$ #$ + &.1&$ #4 !1 "*$3P +$2 .13'.#.-3(23$2 31 5 (++$-3
1 1$,$-3$-2$"3(.-W/+$(-$3 (++$XS
III.1.1.3. Limites
SfSgS]S
ig
-,.45$,$-3#$1 "(-$2$/1.#4(32$4+$,$-32(+ +.-&4$41#V 1" #$$23, (-3$-4$S
S $2
43$412 .-3 #.-" (, &(-? #$2 ,?" -(04$2 .13'.#.-3(04$2 &+.! +$2 /.41 +(,(3$1 +$2
$%%$32#$"$231 "3(.-2:+ , -#(!4+$$31$"'$1"'$1/1(-"(/ +$,$-34-$".11$"3(.-#$+
"+ 22$
SfS]S
)'52%YYJ/215%5.)&/2-%0!2#/52"52%352,%#(!.4$M5.!2#2%#4!.'5,!)2%%.$%580/).43
ih
-/1 3(04$.13'.#.-3(04$P$++$
\h]R
-
+$31 5 (+241"' -3#4%(+\3.104$]\kl]Q
-
$3+V43(+(2 3(.-#$%.1"$2+?&>1$2 5$"#$2/+ &$2
#V "3(5 3(.-+.-&4$2\kmPld]Q
- \lePlf]+$/1(-"(/$#$+ 2$&,$-3 3(.-#$2 1" #$2P %(-#$/ ++($1:
#$47 #(%%("4+3?2R +$ ".-31E+$ #$ + 5$12(.- #$2 ,.+ (1$2P +V(,/.22(!(+(3? #$
, (31(2$1 +$ ,.45$,$-3 2(,4+3 -? #$2 " -(-$2P #$2 (-"(2(5$2 $3 #$2 #$-32 #$2
2$"3$412/.23?1($412# -2+$2#(%%?1$-32/+ -2#$+V$2/ "$S
%(- #$ % "(+(3$1 +$ 31 5 (+ #4 /1 3("($-P
/1./.2$ #>2 emjd +$2 /1?,(22$2 #$2
33 "'$2 (-"(2(5$2 $3 " -(-$2 , 7(++ (1$2 W/1?T(-%.1,?$2X # -2 +$ 31.(2(>,$ .1#1$
\(&41$hi]S
)'52%YZJ/.42@,%$54/215%0!2,%#452%$M5.%!44!#(%02>L).&/2->%$!.3,%X=-%/2$2%R!S/50!2
4/23)/.352#(!.4$M5.!2#$%3%#4)/.2%#4!.'5,!)2%!6!.43/.).3%24)/.$!.3,T!44!#(%R"SR[[S
- 1 (2.- #$ +V(,/.13 -"$ #4 )$4 $-31$ +$2 33 "'$2 \dSdel 7 dSdgdb] $3 +$ %(+ \dSdej 7
dSdejb .4 dSdej7dSdffb]P + #?%.1, 3(.- #$ 3.104$ #.(3 @31$ /+42 ""$-34?$ 04V$-
3$"'-(04$ #&$6(2$S .43$%.(2P (+ $23(,$ 04$ "$ )$4 $23 -?"$22 (1$ : + +(,(3 3(.- #$2
$%%$32(-#?2(1 !+$2\lg]S
+$"341$ #4 31.(2(>,$ .1#1$ $- 3$"'-(04$ !(./1.&1$22(5$ #.-" /.41 " 1 "3?1(T
23(04$2+ ,(2$ $- /+ "$ #V 33 "'$2 /1?T(-%.1,?$2P +V$,/+.( #$ %(+2 /$4 1(&(#$2 $7$1= -3
#$2 %.1"$2 +?&>1$2 $3 2$ #?%.1, -3 +.12 #$ +V //+(" 3(.- #V4- 3.104$ $7"$22(%P 3.43 $-
+ (22 -34-)$4(,/.13 -3$-31$+$2 33 "'$2$3+$%(+S
ii
4-(5$ 4#$2(-"(2(5$2, -#(!4+ (1$2P
43(+(2$#$2 33 "'$2/1?T(-%.1,?$2
5$"4-3.104$:du" 1+V - 3.,($#$"$33$#$-3+ ".-#4(1 :4-$W(-"+(- (2.-(#? +$X
#$eju/ 11 //.13:4-$/$1/$-#("4+ (1$ ! (22?$ 4/+ -#V.""+42(.-\(&41$hj]S
)'52%Y[J
.#,).!)3/.)$>!,%$%,T).#)3)6%-!.$)"5,!)2%3%,/.
III.1.2.1. Définition
+ ".-"$1-$ +$ .4 +$2 2$"3$412 #$ +a 1" #$ #$-3 (1$ 04( -$ #.(5$-3 / 2 @31$ #?/+ "?2
/$-# -304$+$2 431$2+$2.-3P$33.43,.8$-3$-# -3: 2241$1+ 23 !(+(3?#a4-$#$-3 4
".412#4,.45$,$-3#$-3 (1$/1.5.04?S
$33$ #?%(-(3(.- 1$&1.4/$ #.-" +$2 4-(3?2 #$-3 (1$2 #a -"1 &$ $3 +$2 #(2/.2(3(%2 (-31 T
.1 47$3$731 T.1 471$-%.1= -3+a -"1 &$S
.43$%.(2P+ %(7(3?#V4-$#$-3.4#V4-&1.4/$#$#$-32-$/$43@31$1$3$-4$#V4-$% =.-
!2.+4$/4(204$3.43$#$-32$#?/+ "$#$% =.-/'82(.+.&(04$# -2+ " 5(3?!4"" +$\:
+V$7"$/3(.- #$2 #$-32 -*8+.2?$2]S
9.-$ #a -"1 &$ #$-3.T +5?.+ (1$ /$43 +.12 24!(1
4- #?/+ "$,$-3 2.4' (3? .4 -.-S $ ,.45$,$-3 $23 #?2(&-? / 1 +$ 3$1,$ #$ /$13$
#a -"1 &$S
V?5.+43(.- //.13?$ / 1 +V -"1 &$ .22$47 !.4+$5$12? + ".-"$/3(.-
"+ 22(04$ #$ +V -"1 &$S - $%%$3P +V43(+(2 3(.- #$ ,(-(5(2 .4 #$ ,(-(/+ 04$2 ".,,$
ij
-"1 &$ /$1,$3 #$ #(2/.2$1 #V4- -"1 &$ .22$47 #(3 W !2.+4XP (-3$1#(2 -3 3.43
#?/+ "$,$-3#$+ 9.-$#V -"1 &$$-1?/.-2$ 47%.1"$2.13'.#.-3(04$2\"%S
SfSh]S
- 3'?1 /$43(04$ .13'.#.-3(04$P +V -"1 &$ -$ /$43 @31$ #(22."(? #$ + -.3(.- #$ %.1"$S
$2 %.1"$2 $7$1"?$2 /1.5.04$-3 4-$ "3(.-S $+.- + 31.(2(>,$ +.( #$ P 3.43$
"3(.-/1.5.04$4-$1? "3(.-(#$-3(04$$3#$2$-2(-5$12$\(&41$hk]S(-2(P3.432.+(#$
04( 2$13 #a -"1 &$ : 4-$ %.1"$ #$23(-?$ : #?/+ "$1 4- ".1/2 +(!1$P 24!(3 ?& +$,$-3 4-$
%.1"$ ?& +$ $3 #$ 2$-2 .//.2?P 04( 3$-# -"$ : $-31 B-$1 "$ 2.+(#$ $- #(1$"3(.- #$ +
31 "3(.-S
)'52%Y\J2).#)0%$T!#4)/.P2>!#4)/.RVUVS
( + 1? "3(.- $23 4- $%%$3 2$".-# (1$ -?% 23$ : +V.!3$-3(.- #4 #?/+ "$,$-3 #$-3 (1$
&+.! +2.4' (3?P+V.13'.#.-3(23$ --4+$"$2%.1"$2#$1? "3(.-&1;"$:+V -"1 &$S
$- emgk \li]P //+(04? + 31.(2(>,$ +.( #$ $63.- : +V.13'.#.-3($ $3
#?%(-(4-31(-E,$R
- .4+ 1?2(23 -"$,.!(+$R+ 1?2(23 -"$#$+a?+?,$-3:#?/+ "$1P
- .4+ 1?2(23 -"$23 !(+$R+ 1?2(23 -"$#$+a -"1 &$P
- R+ %.1"$,.31("$S
ik
2$-2 #$ + 2.++("(3 3(.-P $3 #$ 2(34$1 "' 04$ #$-3 # -2 +$ 31(-E,$P , (2 "V$23 + 5 +$41
1?"(/1.04$#$21?2(23 -"$204($-31 (-$+$#?/+ "$,$-3#$-3 (1$S
#(23(-&4$ +.1231.(22(34 3(.-2R
dJ,!2>3)34!.#%34!"),%%34>'!,%;,!2>3)34!.#%-/"),%
- 2(srR(+-V8 / 2#$#?/+ "$,$-3Q
- 2( t r R (+ 8 #?/+ "$,$-3 ?& + $3 .//.2? #$ $3 S - / 1+$
#a -"1 &$,(-(,4,.4#$/$13$#a -"1 &$, 7(,4,S
fJ,!2>3)34!.#%34!"),%%34350>2)%52%;,!2>3)34!.#%-/"),%R#!3,%
0,53&2>15%.4SJ
- 2(ttR+$#?/+ "$,$-3$23#.4!+$, (2(-?& +P2$#?/+ "$,.(-2
04$S
+8 -"1 &$,.#?1?$34-$"$13 (-$/$13$#a -"1 &$Q
- 2(ttR2$4+$2$#?/+ "$S?/+ "$,$-3./3(, +#$+ #$-32 -2
2.++("(3 3(.-#4/.(-3#V -"1 &$S-/ 1+$#a -"1 &$, 7(,4,S
eJ,!2>3)34!.#%34!"),%%34).&>2)%52%;,!2>3)34!.#%-/"),%
- 2(ssR2$4+$2$#?/+ "$P(+8 /$13$#a -"1 &$3.3 +Q
- 2(ssR 4"4-#?/+ "$,$-3S
V //+(" 3(.- #$ "$2 2(34 3(.-2 $23 ".,/+$7$ $- .13'.#.-3($ " 1P ".,,$ +$ 1 //$++$
$-emliP(+$23#(%%("(+$# -2+ /1 3(04$#$".-- B31$P/.414-(-#(5(#4#.--?P+
%.1"$ ./3(, +$ -?"$22 (1$ 4 #?/+ "$,$-3 #$-3 (1$ $-5(2 &?S $+ #?/$-# : + %.(2 #$
+V?+ 23("(3?+(& ,$-3 (1$P#$+ 1(&(#(3?.22$42$P#$2/.3$-3( +(3?2#8- ,(04$23(224+ (1$2
$3 "$++4+ (1$2 (-2( 04$ #$ +V$-5(1.--$,$-3 ,42"4+ (1$S $2 % "3$412 (-#(5(#4$+2 -$
/$45$-3@31$".--42:+V 5 -"$S
$ /+42P (+ $23 #(%%("(+$ #V //1?"($1 /1?"(2?,$-3 + 5 +$41 #$ + %.1"$ , 7(, +$ 04$
/$45$-3 24//.13$1 +$2 2314"341$2 #V -"1 &$ 2 -2 5.(1 // 1 B31$ #$ ,.45$,$-32
/ 1 2(3$2S
il
-%(-P + 2/'>1$ .1.T% "( +$ ?3 -3 ".-23(34?$ #a4- $-2$,!+$ #$ /.(-32 $- ,.45$,$-3
/$1/?34$+ 1$+ 3(%P $7"+4 -3 +a$7(23$-"$ #$ /.(-32 1(&.41$42$,$-3 %(7$2P -.42 #$51.-2
"'$1"'$1.4"1?$1#$224//.132#.-3-.42".-- B31.-2+$25 +$412#$23 !(+(3?S
4
-(5$ 4(-"(2(%, -#(!4+ (1$R
im
)'52%Y]J
,,5342!4)/.$T5.%2!#).%-/,!)2%%-"2!33!.4,%#!.!,-!.$)"5,!)2%R\^S
)'52%Y^J52&!#%32!$)#5,!)2%3R--`S$T!02=3).
R[[S
\jj]P# -2+$,@,$$2/1(3P 331(!4?#$25 +$412&4(#$2:"' 04$#$-3\(&41$
id]S
5 +$41ed$23 331(!4?$:+ /1$,(>1$,.+ (1$(-%?1($41$S
jd
)'52%ZUJ!,%523'5)$%3$T!.#2!'%3%,/.).
R[[S
-%(-P
$-fddk\lj]P:+V (#$#$+V(, &$1($31(#(,$-2(.--$++$P #?3$1,(-?
+$5.+4,$1 #("4+ (1$\$-,,g]2414-?"' -3(++.-?3$-#4#$efd24)$32\(&41$ie]S
5 +$41gPi$23#.--?$:+ /1$,(>1$,.+ (1$, -#(!4+ (1$S
)'52%ZVJ/,5-%32!$)#5,!)2%3%4#/%&&)#)%.43$T!.#2!'%3%,/.
R][S
/-"2% $% 2!#).%3 J2.+(# 1(2$1/+42($412#$-32/ 14- 1"2$"3(.--$+1(&(#$.4
4-$+(& 341$ 4&,$-3$+ 1?2(23 -"$/ 1.#.-3 +$#$+V4-(3?/ 22(5$S-/ 1+$ +.12
#V -"1 &$ 1?"(/1.04$ .4 #(%%?1$-3($+S
$2 $%%$32 / 1 2(3$2 (-#?2(1 !+$2 2.-3 (-2(
,(-(,(2?2 4 -(5$ 4 #$2 #$-32 (,,?#( 3$,$-3 #) "$-3$2 47 /.(-32
#V //+(" 3(.-#$+ %.1"$\le]\]S
+ % 43 -.3$1 04$ # -2 +$ 2$-2 5$13(" +P +V.1& -(2 3(.- #$2 %(!1$2 #$2,.#.-3 +$2 -$
2V.//.2$-4++$,$-3 47,.45$,$-32#V?&1$22(.-P# -2+ ,$241$.F(+2".11$2/.-#$-3
4#?/+ "$,$-3/'82(.+.&(04$".,/$-2 3$41#$+V4241$#$-3 (1$/.41+$, (-3($-#$+
#(,$-2(.-5$13(" +$ 4".412#$+ 5($S$4+$2+$2%.1"$2.""+42 +$2/$45$-3 5.(14-$%%$3
(-&1$22(%S
je
!00/24 #/52/..%P2!#).%J 04 -# "$ 1 //.13 #(,(-4$P +V -"1 &$ 4&,$-3$S
%%$"3(5$,$-3P /+42 &1 -#$ $23 + 241% "$ 1 #("4+ (1$P /+42 +$ -.,!1$ #$ %(!1$2
".++ &>-$2 // 13$- -3 4 +(& ,$-3 / 1.#.-3 + 2V ""1.B3S
V -"1 &$ 2V$- 31.45$
1$-%.1"?S
.#,).!)3/.,).'5/L6%34)"5,!)2%/5->3)/L$)34!,%$%,!$%.40!22!00/24;,!
$)2%#4)/.3/,,)#)4!42)#%$%,!&/2#%R4-$,.+ (1$, -#(!4+ (1$$-,?2(.T5$12(.-
%.41-(34- -"1 &$(-%?1($41:4-$%.1"$,?2( + -3$04$+ ,@,$,.+ (1$-.1,.T
/.2(3(.--?$S $ /1(-"(/$ $23 : + ! 2$ #$ + 3'?.1($ #4 W/(04$3 #$ 3$-3$X #$
P+$/(04$3$23/+ -3?.!+(04$,$-3/.411?2(23$1:+ 3.12(.-#$2".1# &$2
\hk]S .3.-2 "$/$-# -3 04V 4"4- 1&4,$-3 '(23.+.&(04$ -$ /$1,$3 #$ )423(%($1
"$33$ //1."'$\lh]S
M/##,53)/.J 3.43$2 +$2 "+?2 #$ +a.""+42(.- 04$ ".-23(34$-3 +$2 "42/(#$2 $3 +$2
%.22$2#$-3 (1$2".-31(!4$-3:23 !(+(2$1+$2 1" #$2#$-3 (1$2S$3$-&1>-$,$-3
#$-3 (1$ ".-23(34$ 4- % "3$41 #$ 1?2(23 -"$ 4 #?/+ "$,$-3S $ ,@,$P 4-$
".41!$#$ ""$-34?$$3#$2#$-32:"42/(#$2' 43$2/ 13("(/$-3:+a -"1 &$
/ 22(%S.43$%.(2P+V'.,,$$23/$4$-.""+42(.-#V(-3$1"42/(#($, 7(, +$\
]P(+
$23 /+42 2.45$-3 $- /.2(3(.- #$ 1$/.2 \2 4% +$ !147., -]P #.-" + -.3(.-
#V.""+42(.-$-3$1,$2#V -"1 &$/ 22(%$23:,.#?1$1S
SfSe]S
?3 !+(34-$1$+ 3(.-$-31$+ 38/.+.&($$3+V -"1 &$,42"4+ (1$R
-
! 490/,/')% "2!#(9&!#)!,%J " 1 "3?1(2?$ / 1 4-$ ,42"4+ 341$ % "( +$
'8/$13.-(04$S
$2 ,42"+$2 , 23(" 3$412P $3 $- / 13("4+($1 , 22?3$1 $3 3$,/.1 +
\(&41$ if]P $3 +$ / 1 ++?+(2,$ #$2 /+ -2 / + 3(- $3 .""+42 +P 2V.//.2$-3 47
#?/+ "$,$-32#$-3 (1$2S -2+$2$-2'.1(9.-3 +P(+$-1?24+3$4-$#(,(-43(.-#$2
jf
".,/.2 -3$2 #$ 5$23(!4+.T5$12(.- #$2 (-"(2(5$2 $3 #$ ,?2( +(2 3(.-S $33$
38/.+.&($!?-?%("($#.-"#V4-!.- -"1 &$- 341$+S
-
! 490/,/')% $/,)#(/&!#)!,%J " 1 "3?1(2?$ / 1 4-$ 3.-("(3? ,42"4+ (1$ ,.(-#1$
$3 4-$ #(5$1&$-"$ , 7(++.T, -#(!4+ (1$S
$2 ,.45$,$-32 #a?&1$22(.- $3 #$
,?2( +(2 3(.- ,.+ (1$ (-2( 04$ #$ 5$23(!4+.5$12(.- (-"(2(5$ 2$1.-3 /+42 (2?2
\+>51$2 3.-$2]S
(-2(P /.41
P + 38/.+.&($ #4 / 3($-3 (-3$15($-3 2.(3 ".,,$ % "3$41
,.#?1 3$41 \38/$ #.+("'.% "( +] 2.(3 ".,,$ % "3$41 1$-%.1= 3$41 \38/$ !1 "'8% "( +]P
# -2 + ,$241$ .F (+ ".-31E+$ + #$-2(3? .22$42$P + /4(22 -"$ ,42"4+ (1$P $3 #.-" +$2
%.1"$2.""+42 +$2\kk]S
)'52%ZWJ
,,5342!4)/.$%3$%5802).#)0!58-53#,%3-!34)#!4%523R4%-0/2!,%4-!33>4%2SR]\S
V(,/.13 -"$ #$ +V -"1 &$ ,42"4+ (1$ #.(3 #.-" @31$ #?3$1,(-?$S .41
P +
,.1/'.+.&($, -#(!4+ (1$$23+V$7/1$22(.-#$+ %.-"3(.-,42"4+ (1$S -22.- - +82$
"?/' +.,?31(04$P(+,$3$-?5(#$-"$+ W2314"341$(-3$1-$#$+ , -#(!4+$XS/ 13(1#4
/.(-3(04V(+#?"1(3".,,$+$"$-31$&?.,?31(04$#$+ !1 -"'$,.-3 -3$P(+31 "$#$2
7$2 1 8.-- -32R (TP (T,\ 5$" , /.(-3 #V(-%+$7(.- #4 ".-3.41 -3?1($41 #$ +
28,/'82$ , -#(!4+ (1$ ".,/1(2 $-31$ +$ /.(-3 $3 +$ /.&.-(.-]P $3 (T\ 5$"
"$-31$#4".+#4".-#8+$, -#(!4+ (1$2(34?241+ +(&-$- 2(.-T! 2(.-]S
#(5$1&$-"$
, 7(++.T, -#(!4+ (1$\?5 +4?$/ 1+V -&+$T(T,]$32413.43+V 1", -#(!4+ (1$,T
(TP".-23(34$-3+$2$23(, 3$412+$2/+42%( !+$2#$+V -"1 &$,42"4+ (1$\(&41$ig]S
jg
)'52%ZXJ
)'.%3$%,M!.!,93%$%
RYS
jh
+V$7/ -2(.-2.-3(-".1/.1?2# -2+$2 1"2/.41#?/+ "$1+$21 "(-$2$-#(1$"3(.-#$+V.2
".13(" +#$-2$S
)'52%ZYJ/50%&2/.4!,%$M5./3-!.$)"5,!)2%3%#-/.42!.4
,M/3#/24)#!,#/-0!#4%.0>2)0(>2)%%4,M/3!,6>/,!)2%30/.')%58!5#%.42%
.41
\md]P"V$23+ /1$22(.-$7$1"?$241+V.2".13(" +04(".-23(34$+V -"1 &$
/+43E304$+$#?/+ "$,$-31?$+#$21 "(-$2# -2"$#$1-($1S
S
-2+$" #1$#$"$31 5 (+P-.42#?"1(1.-2+$2,?3'.#$2#V -"1 &$2$+.-#$47&1 -#$2
?".+$2#$+V.13'.#.-3($R+V#&$6(2$$3+ 3$"'-(04$(./1.&1$22(5$P (-2(04$+V //.13#$
+V -"1 &$204$+$33(04$S
ji
III.2. Applications cliniques
II.2.1.1 Introduction
3$"'-(04$ #&$6(2$ 43(+(2$ 4- 2823>,$ #V -"1 &$ 1?"(/1.04$ .F 3.42 +$2 ?+?,$-32
2.-3 #?/$-# -32 +$2 4-2 #$2 431$2R 3.43$2 +$2 #$-32 2.-3 ! &4?$2 $3 2.+(# 1(2?$2 +$2
4-$2 47 431$2\me]S
".-"$/3(.-#$+V -"1 &$# -2"$33$3$"'-(04$$23$22$-3($++$S
1?5.+43(.--? +V.13'.#.-3($ 47 3 32T-(2 # -2 +$2 --?$2 hd $3 id \j]S
+
# /3?+V // 1$(+#&$6(2$:2$2!$2.(-2S$+.-+4(P+ "+?#$+ 23 !(+(3?P#$+ %.-"3(.-P#$
+V' 1,.-($ % "( +$ $3 #$ + 2 -3? / 1.#.-3 +$ / 22$ / 1 +$ /.2(3(.--$,$-3 ".11$"3 #$
+V(-"(2(5$(-%?1($41$# -22.-24//.13.22$47\km]S$+4(T"($23.!3$-4/ 1+V -"1 &$04$
".-2(#>1$ ".,,$ W+ -.3(.- + /+42 %.13$ $- .13'.#.-3($XP $3 04( #.(3 @31$
$-31$/1(2#>2+$2/1$,(>1$2/' 2$2#$31 (3$,$-3 5$""$04V(+ //$++$W,!02>0!2!4)/.
$M!.#2!'%X\mg]S
?2$15?$:+V 1" #$, -#(!4+ (1$P+ /1?/ 1 3(.-#V -"1 &$ /.41.!)$"3(%#$/+ "$1+$2
#$-32$-/.2(3(.-#$1?2(23 -"$:+V?& 1##$2%.1"$204(+$412.-3 //+(04?$2P"V$23T:T#(1$
$-/.2(3(.-#$#(23.T5$12(.-2 -2,?2( +$1+$412 /$7S(-2(P+.12#$+V //+(" 3(.-#$2
#$ "+ 22$
P + ".,/.2 -3$ '.1(9.-3 +$ #$ ,?2( +(2 3(.- #$2 ,.+ (1$2 , -#(!4+ (1$2
(-2( 04$ 2$2 1?/$1"422(.-2 -3?1($41$2 \5$23(!4+.T5$12(.- #$2 (-"(2(5$2] 2V$- 31.45$-3
#(,(-4?$2S
".11$"3(.-#$+ "+ 22$
jj
II.2.1.2 La préparation d'ancrage originelle selon TWEED
$33$ /1?/ 1 3(.- #V -"1 &$ #?!43$ /1>2 +(&-$,$-3 $3 -(5$++$,$-3 #$ +V 1" #$
, -#(!4+ (1$S
V 1" #$ , -#(!4+ (1$ $23 +.12 ?04(/?$ #V 1"2 1$"3 -&4+ (1$2 24""$22(%2
#$2$"3(.-2/+42(,/.13 -3$2, (21?#4(3$2# -2+$41/ 13($31 5 (++ -3$S
- 8 (-".1/.1$ #$2 W3(/ ! "* !$-#2XP #?%.1, 3(.- #$ #$47(>,$ .1#1$ $-31 B- -3 4-$
5$12(.-".1.-.T#(23 +$2413.43$2+$2#$-32#$22$"3$412/.23?1($412S
V(,/.13 -"$#$"$2
#?%.1, 3(.-2$23 ""$-34?$:"' 04$5(2(3$$3#?/$-##$+ 2?5?1(3?#4" 2\2?5?1(3?#$
+ , +.""+42(.-P#41?$$3(-3$-2(3?#$+ ,?" -(04$#$"+ 22$
]S
-2+$2" 2#a -"1 &$, 7(, +.F+$2
#$"+ 22$
5.-3@31$43(+(2?$2(-3$-2?,$-3P+
#$47(>,$,.+ (1$, -#(!4+ (1$5.(3+ / 13($#(23 +$#$2 % "$.""+42 +$1$".45$13$/ 1
+ &$-"(5$S $2 , 1"'$2P .4 W23$/2X #$ ".,/$-2 3(.-P , (-3($--$-3 + /+ -?(3? #$
+V 1" #$, -#(!4+ (1$S
$/$-# -3P"$2W3(/! "*!$-#2X.-34-$(-"(#$-"$241+$2$"3$41 -3?1($4104(1$=.(3
+.12 4-$ %.1"$ (-&1$22(5$S
V?04(+(!1$ #4 2823>,$ % (3 2.45$-3 1?%?1$-"$ 4 W
28,?31(04$X#?"1(3$-,?" -(04$.13'.#.-3(04$\(&41$ii]S
)'52%ZZJ15),)"2%$5N!39->42)15%O#!53>0!2,%4)0"!#+
$33$ %.1"$ (-&1$22(5$ -3?1($41$ ?3 -3 //+(04?$ 4 -(5$ 4 #4 !1 "*$3P $++$ / 22$
&?-?1 +$,$-3$- 5 -3#4"$-31$#$1?2(23 -"$#$2(-"(2(5$2P 5$"/.41".-2?04$-"$+
%.1, 3(.-#V4-,.,$-3".1.-.T5$23(!4+ (1$S
jk
.41+433$1".-31$"$3$%%$3(-#?2(1 !+$P,$3$-/+ "$#$2
#$"+ 22$
//+(T
04?$2#V4-$/ 13 47,.+ (1$2, 7(++ (1$2P$3#V 431$/ 13 47(-"(2(5$2, -#(!4+ (1$2:
+V (#$#$"1."'$322.4#?2241+V 1"$-31$" -(-$2$3(-"(2(5$2+ 3?1 +$2\(&41$ij]S
)'52%Z[J2!#4)/.).4%2-!8),,!)2%$%#,!33%
4 3.104$ 1 #("4+.T+(-&4 + $23 (-".1/.1? 4 -(5$ 4 (-"(2(% /.41 ".-31$T! + -"$1 +$
,.45$,$-3#$5$12(.-".1.-.T+(-&4 +$04( "".,/ &-$+a "3(.-#$"$2?+ 23(04$2S
.41?5(3$1#$2$%%$32(-#?2(1 !+$2:+V 1" #$, 7(++ (1$24(3$ 47?+ 23(04$2#$"+ 22$
P
"$++$T"( $23 ?04(/?$ #a4- 1" #$ 23 !(+(2 3(.- \-$431$ $3 #$ /+$(-$ 3 (++$] $3 #a4-$ %.1"$
$731 T.1 +$S
-$ %.(2 + /1?/ 1 3(.- #$ +V 1" #$ , -#(!4+ (1$ 1? +(2?$P + /' 2$ #$ ".11$"3(.- #$ +
#$-341$/$43".,,$-"$1S
".11$"3(.-#$+ "+ 22$
431 5$12#$2
#$"+ 22$
$23
1$2/.-2 !+$#V4-1$"4+W$-, 22$X#$+a 1" #$24/?1($41$S
$/$-# -3P "$33$ 3$"'-(04$ $23 22$9 #(%%("(+$ : ".-31E+$1P 5$" 2.45$-3 +V // 1(3(.- #$
,.45$,$-32 / 1 2(3$2P : 2 5.(1 4-$ (-&1$22(.- (-"(2(5$ \+$2 ?+ 23(04$2 #$ "+ 22$
-V 11(5 -3 / 2 : ".,! 331$ +V "3(.- #$2 W3(/2 ! "*X] $3 / 1%.(2 4-$ ?&1$22(.- ,.+ (1$
, 7(++ (1$P#V.F4-$.45$1341$#4/+ -#V.""+42(.-$3#4S3+V.45$1341$#$"$2/+ -2
-$5 / 2# -2+$2$-2#$+ ".11$"3(.-#$+ , +.""+42(.-S
jl
- % (3P "$33$ 231 3?&($ #(22."($ +$2 #$47 1" #$2 4 ".412 #$ + /1?/ 1 3(.- #$ + #$-T
341$ \1$/.2(3(.--$,$-3 (-"(2(%P +(&-$,$-3P -(5$++$,$-3] /.41 +$2 "..1#.--$1 $-24(3$
/ 1 + ,?" -(04$ #$ "+ 22$
S
$ # -&$1 #$ "$ ".-"$/3 W 1" #$ ".-31$ 1" #$X 1?2(#$
# -2+$% (304$+ 1?422(3$#$231 (3$,$-32#$"+ 22$
2.-3
(#$-3(04$2P 5.(1$ 4&,$-3?2P + ,?" -(04$ 2$4+$ -$ /$43 1?#4(1$ + , +.""+42(.- 2 -2
4-$!.--$1?/.-2$#$"1.(22 -"$$32 -2"../?1 3(.-S-$1??5 +4 3(.-#$+ 231 3?&($
#$31 (3$,$-3".-#4(3 +.122.45$-3:#$2$731 "3(.-224//+?,$-3 (1$2 4, 7(++ (1$.4
:4-$"'(141&($#a 5 -"$,$-3, -#(!4+ (1$S
$ /1(-"(/$ $23 #$ 24//1(,$1 /.41 "' 04$ /' 2$ #$ 31 (3$,$-3 +$2 ".,/.2 -3$2
#?% 5.1 !+$2 4 ,.45$,$-3 2.4' (3?S
V(-3$-2(3? $3 + #(1$"3(.- #$2 #?/+ "$,$-32
#?2(1?22.-3, B31(2?$2P3.43$-".-31E+ -3+ /.2(3(.-#$22314"341$2#V -"1 &$S
$2%.1"$2$731 T.1 +$2.1($-3?$2\].4W%.1"$2#(1$"3(.--$++$2X\]P 22."(?$2 47
#.2 &$2#$2(-%.1, 3(.-2#?+(51?$2/ 1+$2 1"2 // 13($--$-3:"$".-"$/3S++$22.-3#$
31.(2 38/$2P $- %.-"3(.- #$ +V.1($-3 3(.- #$ + 31 "3(.- \#?3$1,(-?$ / 1 #$2 "1."'$32
//+(04?2241+$" 204$$731 T.1 +]# -2+$/+ -2 &(33 +/ 11 //.13 4/+ -#V.""+42(.-S
++$2 #.(5$-3 @31$ / 1% (3$,$-3 .1($-3?$2 $- %.-"3(.- #4 2"'?, % "( + $3 #4 38/$ #$
,.45$,$-32.4' (3?S
.41
\mi] R W4-$ 3$"'-(04$ 04( -$ 2$ 2$13 / 2 #V4- " 204$ $731 T.1 +
1$22$,!+$ : 4- - 5(1$ 2 -2 &.45$1- (+ 04( - 5(&4$ $- 24(5 -3 +$ / 1".412 04( .%%1$ +$
,.(-2#$1?2(23 -"$P2 -2) , (21?%+?"'(1:2 #$23(- 3(.-?5$-34$++$XS
\(&41$ik]S
jm
$41 ,.#$ #V "3(.- #.(3 1?/.-#1$ : + +.( #$2 31.(2 '4(3R $7$1"$1 4-$ %.1"$ #$ l .-"$2
\fdd&]P#41 -3l).412 /1>2+V "3(5 3(.-P:1 (2.-#$l'$41$2#$/.13/ 1).41\mj]S
)'52%Z\J
,,5342!4)/.$%,!&/2#%%842!L/2!,%;42!#4)/.(!54%0!2
R^ZS
%43/.%&&%4352,!-/,!)2%-!8),,!)2%0/52#/.42%2#%58$%3
$%#,!33%
+ , -#(!4+$P+$2#$38/$W231 (&'3/4++'$ #&$ 1X\31 "3(.-+?&>1$,$-3.!+(04$
5$12 +$ ! 2 #$ i : edu] ".-31E+$-3 + 5$23(!4+.5$12(.- #$ +V(-"(2(5$ , -#(!4+ (1$S ++$2
2a ""1."'$-3 +.12 #(1$"3$,$-3 241 +$2 "1."'$32 -3?1($412 #$ +a 1" #$ , -#(!4+ (1$S
.3.-2 04$ "$2 W X /$45$-3 422( @31$ //+(04?$2 #>2 +V?3 /$ #$ -(5$++$,$-3 %(-
#$+(,(3$1"$33$5$23(!4+.5$12(.-(-"(2(5$, -#(!4+ (1$\mk]\(&41$il]S
)'52%Z]J
,,5342!4)/.$M5. 0!2
R^ZS
%43%3%&&%43,/23$%,!02>0!2!4)/.$M!.#2!'%R3!.33/,,)#)4!4)/.-!8),,!)2%SR^\S
.41 ,?+(.1$1 +V$%%(" "(3? #$ + /1?/ 1 3(.- #V -"1 &$P
,$3 $- /+ "$ +$
W36$+5$T36.2823$,X\ //$++ 3(.-# -2+$2" 22 -2$731 "3(.-]S
kd
-2 "$ " 2P + /1?/ 1 3(.- #$ +V -"1 &$ , -#(!4+ (1$ /1(5(+?&($ +$ ".-31E+$ #4 2$-2
5$13(" +$-2$"3.1(2 -3+$2#?%.1, 3(.-2#$+V 1"S
$2#?%.1, 3(.-2#$W3(/T! "*!$-#2X
-$ 2$ %.-3 04$ 241 f #$-32 , -#(!4+ (1$2 \1?2(23 -"$ ,.!(+$]P $3 +$2 431$2 #$-32 #$
+V 1" #$/ 13("(/$-3:+ /1?5$-3(.-#$21? "3(.-2/ 1 2(3$2\1?2(23 -"$23 !(+$]S
V$-2$,!+$ #$ +a 1" #$ \ef #$-32] 2$13 #.-" #a -"1 &$ / 22(% /.41 +$ #?/+ "$,$-3 #$
#$47#$-322$+.-+$/1(-"(/$#$+V -"1 &$#(%%?1$-3($+\.41?"(/1.04$]S
1? +(2 3(.-#$+
/1?/ 1 3(.-#V -"1 &$$2331>2#?3 (++?$$3/1?"(2$\ !+$ 4e]S
!",%!5VJ2>0!2!4)/.$M!.#2!'%
ke
)'52%Z^J4!"),)3!4)/.$%,!02>0!2!4)/.$T!.#2!'%-!.$)"5,!)2%
.43 4+.-&#$+ /1?/ 1 3(.-P+ 1? "3(.- -3?1($41$#43(/! "*[(-&1$22(.- 5$"/+42
.4 ,.(-2 5$23(!4+.5$12(.- (-"(2(5$ [ $23 ".-31E+?$ / 1 4- 2.43($- -3?1($41 \ $3
?+ 23(04$2 5$13(" 47 -3?1($412]S
#(1$"3(.- #$2 %.1"$2 //+(04?$2 # -2 + 9.-$
-3?1($41$&>1$+$".-31E+$#4#$47(>,$.1#1$# -2+ 9.-$/.23?1($41$\(&41$jd]S
.3.-2 04$ #$/4(2 +a43(+(2 3(.- #$2 W%.1"$2 #(1$"3(.--$++$2XP +$ #$&1? #$ /1?/ 1 3(.-
#a -"1 &$$23#V 5 -3 &$+(? 42$-25$13(" +04a 42$-2 -3?1.T/.23?1($41R+ 5 +$41#a4-
3(/T! "*-a /+42 4"4-$2(&-(%(" 3(.-$-#$'.12#$2.-".-3$73$"+(-(04$P$++$#?/$-##4
38/$% "( +#4/ 3($-3$3#$+a(-"+(- (2.-#4/+ -#a.""+42(.-, -#(!4+ (1$P"a$23T:T#(1$#$
+ 2(34 3(.-5$13(" +$#$+a(-"(2(5$(-%?1($41$S4"4-$(-%.1, 3(.--a$23/+42?5.+43(5$04$
+$#$47(>,$.1#1$S
$ /+42P "' 04$ #$&1? #$ %$1,$341$ #$ +a -&+$ $23 4- #$&1? #$ & &-? 241 +$
1$/.2(3(.--$,$-3 (-"(2(%
P $3 #.-" 4-$ ?".-.,($ #a$2/ "$ -?"$22 (1$ 241 +a 1" #$
, -#(!4+ (1$S-$%.(2+V 1" #$, -#(!4+ (1$23 !(+(2?$P+ /' 2$#$,?" -(04$#$"+ 22$
/.411 +.12#?!43$1S
kf
)'52%[UJ
!->#!.)15%$%#,!33%
3%,/.L
,?" -(04$#$"+ 22$
2$+.-T
\(&41$jd]R
-(-31 T 1" #$R
4 , 7(++ (1$R 1" #$ #(23 +(2 3(.- 22."( -3 !.4"+$2 #V.45$1341$ $-31$ +$2
,.+ (1$2 $3 1$22.132 #$ #(23 +(2 3(.- $- #(23 + #$2 /1?,.+ (1$2P 5$" 2.43($-
5$13(" +/ 1'(&'/4++'$ #&$ 1\ ]
+ , -#(!4+$R 1"#$23 !(+(2 3(.-#$/+$(-$3 (++$S
-(-3$1T 1" #$R
+ 23(04$2 (-3$1, 7(++ (1$2 #$ "+ 22$
kg
III.2.2. Ancrage en technique Bioprogressive
V?3 !+(22$,$-3 #4 /1.)$3 #$ 31 (3$,$-3 1$/.2$ 241 +$ ".-"$/3 #$ 5(24 +(2 3(.- #$2
.!)$"3(%2 #$ 31 (3$,$-3 \] %(- #a(-(3($1 4- 31 (3$,$-3 #.-3 .- ".-2314(3 +a(, &$
,$-3 +$ #$ + %(- \edd]S 5$" +V?+ !.1 3(.- #4 /1.&1 ,,$ (-%.1, 3(04$ $1.! 2$cP +$
".-"$/3 #$ + /+ -(%(" 3(.- 5(24$++$ #4 31 (3$,$-3 \] $3 #$ +V(, &$1($ 2.-3 (-3?&1?2
/.41.!3$-(1+$/1.)$3#$31 (3$,$-3\edePedf]S
kh
$2823>,$#$/1.)$3#$31 (3$,$-3".,/.13$+4('4(3?3 /$2\ml]R
".,/ 1 (2.- / 1 24/$1/.2(3(.- #4 31 "? #$ /1?5(2(.- $3 #4 31 "? "?/' +.,?31(04$
(-(3( +.%%1$4-$5?1(3 !+$, 04$33$#$31 (3$,$-3S
$#?/+ "$,$-3#$+V(-"(2(5$, -#(!4+ (1$$23?5 +4?/ 1+ 24/$1/.2(3(.-#$2+(&-$2(T
,\ 5$",$-1$&(231?]/.41.!3$-(14-$/.2(3(.-(#? +$/ 11 //.13 4/+ -#$-3 (1$
#$
\/+ -T.&P"%S
SgSgS]\(&41$je]\edePedf]S
)'52%[VJ50%20/3)4)/.,/#!,%R)L-!6%#-%.2%')342>SJ
>6!,5!4)/.$%3-/56%-%.43).#)3)&3%4-/,!)2%3RVUVHVUWS
- $- #?#4(3 + +.-&4$41 #V 1" #$ $- %.-"3(.- #$ + ,.+ (1$ $3 + -?"$22(3? ?5$-34$++$
#V(-#(04$1#$2 54+2(.-2S
ki
.3.-204$/.41
\edg]P+$/.41"$-3 &$#V$731 "3(.-2+.12#431 (3$,$-3#$+
"+ 22$
$+.- + -?"$22(3? #$ ".-31E+$ #$ +V(-"(2(5$ , -#(!4+ (1$ # -2 +$ 2$-2 2 &(33 +P +
/$1,$3 #V -3("(/$1 +$2 "3(5 3(.-2 ,?" -(04$2 : /1?5.(1 R +$41 - 341$P + 04 -3(3? #$
#?/+ "$,$-3$3#V -"1 &$2:& &-$1.4:/$1#1$\mmPedh]S
V -"1 &$/.411 +.12@31$04 +(%(? 4-(5$ 4#$+ /1$,(>1$,.+ (1$, -#(!4+ (1$#$R
7(, +R+ /1$,(>1$,.+ (1$, -#(!4+ (1$-$#.(3/ 2!.4&$1P#M%34 ,M!.#2!'%
2%#(%2#(> ,/23 $5 42!)4%-%.4 0!2
$% #,!33%
kj
V%202).#)0%J
/2315%,%$>0,!#%-%.402/6/15>.%3%,)-)4%0!3;5.%$%.4H-!)3
#/.#%2.% 5. '2/50% $% $%.43H #% $%2.)%2 $%62! ?42% .)6%,> $!.3 5.% 02%-)=2%
>4!0%H05)334!"),)3>H!&).$%#/.34)45%25.%N5.)4>0!33)6%OK
$2#$-32#$22$"3$412+ 3?1 472.-3#.-" +(&-?$2$3-(5$+?$2# -24-/1$,($13$,/2R(+
2V &(3 #V(#? +(2$1 +$41 /.2(3(.- +$ /+42 1 /(#$,$-3 /.22(!+$ $3 -.- #V'8/$1".11(&$1 +$41
7$ /.41 1?2(23$1 47 ,.45$,$-32S
(-2(23$ 241 +V(#? +(2 3(.- #$ +V 1" #$
, -#(!4+ (1$ : +V (#$ #$2 "(-0 %.1,$2 #V 1"2 /$-3 ,.1/'(04$2 %(- #$ ".-2$15$1 +
%.1,$#V 1" #$- 341$++$\edi]S
$2#$-32/.23?1($41$22.-3$-24(3$2.+(# 1(2?$2 5$"4-
2$&,$-3#V 1"1(&(#$P#$3$++$2.13$04$W2(+V +(&-$,$-3 ?3?".11$"3$,$-31? +(2?P(+-$
2$1 /+42 -?"$22 (1$ #$ #?/.2$1 +$2 2$&,$-32 #V 1"2 + 3?1 47 )4204V: + %(- #4
31 (3$,$-3X\]S++$2/.411.-3 +.12@31$1?4-($2/ 1+$2823>,$ "3(%P"V$23T:T
#(1$+$2?+ 23(04$2(-3$1, 7(++ (1$2#$"+ 22$
S
$ -(5$++$,$-3 $3 +$ #?/+ "$,$-3 #V4- &1.4/$ #$ #$-32 -$ 2.-3 #.-" ) , (2 $%%$"34?2
2(,4+3 -?,$-3P %(-#$-$/ 231./2.++("(3$1+V -"1 &$S
+$-#?".4+$+$2$".-#/1(-"(/$S
W.$ 02).#)0%J (!15% 3>15%.#% ->#!.)15% $/)4 )-0>2!4)6%-%.4 ?42% 4%2-).>%
!6!.415%.%$>"54%,!35)6!.4%K
-%.-"3(.-#$+ -?"$22(3?#V -"1 &$?5 +4?$/ 1+ P#$2 47(+( (1$2#$38/$$731 T
.1 +.4(-31 T.1 +/$45$-3@31$ ).43?2\edj]S
M!2#$%"!3%/5$M54),)4>\hk]\(&41$jf]
kk
)'52%[WJ2>3%.4!4)/.$%,M!2#$%"!3%
$3 47(+( (1$$23(-#(04?:+V 1" #$, -#(!4+ (1$+.12#4/.13#$2
#$"+ 22$
%(-#$
/+ "$1+$2#$-32$-2(34 3(.-#$1?2(23 -"$% "$ 47$%%$32#$,?2(.5$12(.-#$+V 1" #$S
$2/1?T "3(5 3(.-22.-3 +.121? +(2?$2R
- . 0/34>2)%52J 4- 1$#1$22$,$-3 $3 4- -"1 &$ ,.+ (1$P (-".1/.1 3(.- #$
".41!41$2 -3(T5$12(.- \(&41$ jh] $3 -3(T1.3 3(.- \3(/T! "* $3 3.$T(- ,.+ (1$]
(-2( 04$ #V4- 3.104$ 1 #("4+.T5$23(!4+ (1$S
$ 3.104$ 1 #("4+.T5$23(!4+ (1$
$-&$-#1$4-$1.3 3(.-#$2#$-32P3$++$04$"$2.-3+$2".41.--$204(2$+(-&4 +$-3
$3-.-/ 2+$21 "(-$204(2$5$23(!4+$-3S
+% 43 +.12 ).43$1:+V 1"#$+V$7/ -2(.-
31 -25$12 +$ %(-#$#?/+ "$1+$21 "(-$2# -2+ ".13(" +$.22$42$$73$1-$P9.-$
/$41?2.1! !+$$3#.-"% "3$41#$23 !(+(3?S
V(,/.13 -"$#$+ ".41!41$#(23 +$P
3(/T! "*P5 1($2$+.-
5$"+$#$&1?#V -"1 &$#?2(1?R
o -"1 &$,(-(,4,Reiu
o -"1 &$,.8$-Reiu:gdu
o -"1 &$, 7(,4,Rgdu
- . !.4>2)%52 J4- ++.-&$,$-3#4#?"1."'$,$-3/.23?1($41#$+V 1"/$1,$34-$
(-&1$22(.-#$2(-"(2(5$2 %(-#$/$1,$331$+$41-(5$++$,$-3\(&41$jg]S
kl
)'52%[XJ#4)6!4)/.0/34>2)%52%$%,M!2#$%"!3%J,/23$%3/.).3%24)/.$!.3,%345"%3-/,!)2%3H,!
0!24)%!.4>2)%52%$%,M!2#0,/.'%$!.3,%6%34)"5,%H2%6%,!.4,M!#4)/.).'2%33!.4%$5$)30/3)4)&R^^S
V #).-"3(.-#V4-3.104$".1.-.T+(-&4 + -3?1($412V.//.2$:+ 5$12(.-5$23(!4+ (1$#$2
(-"(2(5$2 #4$ 4 3(/T! "* /.23?1($41 \%.-"3(.- #$ +$41 /.2(3(.--$,$-3 (-(3( +P "%S
SgS]S
V(-3$-2(3?#4".4/+$ (-2("1??#.(33.4).412@31$24/?1($41$ 4,.,$-3(-#4(3/ 1+$3(/
! "* %(-#$, (-3$-(1+V 7$#$+V(-"(2(5$$3+$"$-31 &$#$2.- /$7# -2+ 28,/'82$S
+V?04(+(!1$P+$2,.,$-32#43.104$ -3?1($41".1.-.T+(-&4 +$3#43(/T! "*/.23?1($41
2V ).43$-3P"$04(&?->1$#$47".4/+$2#$%.1"$2 &(22 -3# -2+$,@,$2$-2P (-2(04$
#$2%.1"$2?&1$22(5$2/.23?1($41$2$3(-&1$22(5$2 -3?1($41$2\(&41$jhP(&41$ji]S
%.1"$#?+(51?$/ 1"$3 1"2$2(34$$-31$jd$3edd&S
)'52%[YJ#4)6!4)/.3$%,M!2#$%"!3%H!6%#;'!5#(%,%3%&&%43$54)0L"!#+-/,!)2%
%4;$2/)4%#%58$54/215%).#)3)6%#/2/./L,).'5!,
km
)'52%[ZJ2#$%"!3%!6%#,M!#4)/.#/-").>%$54)0L"!#+-/,!)2%%4$54/215%
#/2/./L,).'5!,).#)3)&J,%3%&&%433T!*/54%.4H'>.>2!.4$%58#/50,%3$%&/2#%3$%
-?-%3%.3H!).3)15%$%3&/2#%3>'2%33)6%30/34>2)%52%3%4).'2%33)6%3!.4>2)%52%3K
$+.-
\edm]P+$#$&1?#$#(%%("4+3?#4" 2#?3$1,(-$+$,.#$#V$,/+.(#$+V 1"
#$! 2$S
+/$43@31$/.2(3(.--?W:"'$5 +X/.411$-%.1"$1+V 1"2.4/+$".-3(-4PW2.42T
) "$-3X:+V 1"".-3(-4/.41 ,?+(.1$1+$".-31E+$ -3?1($41P.4$-".1$$-2$&,$-3 3(.-
"+ 22(04$/.41.1& -(2$1+$2,.45$,$-32#$2#(%%?1$-322$"3$412(-#(5(#4$++$,$-3S
M!2#,).'5!,\(&41$jj]
1" ,.5(!+$.42.4#?P%(7? 47!.(3($12,.+ (1$2P //48?2413.43$2+$2% "$2+(-&4 +$2
#$2#$-32(-%?1($41$2S$2#$47!.4"+$2#$".,/$-2 3(.-/$1,$33$-3+$1?&+ &$ -3?1.T
/.23?1($41\(&41$jj]S
+1$-%.1"$+V -"1 &$#$2,.+ (1$2(-%?1($41$2$3/$43@31$ 22."(?
:4- 1"#$! 2$\jj]S
)'52%[[J2#,).'5!,R[[S
ld
%N,)0"5-0%2O/50!2%L#(/#3,!")!,\(&41$jk]
)'52%[\J2>3%.4!4)/.%4%&&%43$50!2%L#(/#3,!")!,RVVUS
/1$22(.- + !( +$ $23 31 -2,(2$ 47 ,.+ (1$2 , -#(!4+ (1$2 04( 2$ 1$#1$22$-3 $3 2$
#(23 +$-3P + / 13($ -3?1($41$ $23 ".-23(34?$ #V4- ?"1 - + !( + +?&>1$,$-3 $- 5 -3 #$2
(-"(2(5$2P, (-3$- -3+ +>51$(-%?1($41$:#(23 -"$#$2(-"(2(5$2, -#(!4+ (1$2S
/1$22(.- +(-&4 +$ "$-31(%4&$ /1.5.04$ 4- #?/+ "$,$-3 #$2 (-"(2(5$2P #$2 " -(-$2 $3
#$2/1?,.+ (1$2, -#(!4+ (1$2$-#(1$"3(.-5$23(!4+ (1$\(&41$jk]S
+ $23 (-#(04? $- 3 -3 04V -"1 &$ ,8.%.-"3(.--$+$- " 2 #$ #?2?04(+(!1$ ,42"4+ (1$S
$+.-
$3
\eee]P+.12#4/.13#$2?+ 23(04$2(-3$1, 7(++ (1$2#$"+ 22$
P (+ /.41 5 -3 &$ #$ 1$-%.1"$1 +V -"1 &$ ,.+ (1$ (-%?1($41P 5.(1$ #$ 1$#1$22$1 +$2
le
,.+ (1$2 $3 #$ ".,! 331$ + /1$22(.- #$ + +>51$ (-%?1($41$ /.41 /$1,$331$ +$
,.45$,$-35$23(!4+ (1$#$2(-"(2(5$2$3#$2" -(-$2(-%?1($41$2\(&41$jl]S
)'52%[]J/.42@,%$%,!-/,!)2%-!.$)"5,!)2%0!2,%0!2%L#(/#3,!")!,
,/23$%,M!00,)#!4)/.$%
$%#,!33%
RVVUS
V /1>2
$3 \eefPeeg]P (+ $- 1?24+3$ 4-$ W 4&,$-3 3(.- #$ +
+.-&4$41#$+V 1" #$(-%?1($41$XP (# -3:1?2.4#1$#$+?&$12" 2#V$-".,!1$,$-3(-"(2(%
3$+204$+$2$-".,!1$,$-322$".-# (1$2:+ "1.(22 -"$3 1#(5$"'$9+$2)$4-$2 #4+3$2S
!&/2#%%842!L/2!,%
+.-&4$41 $3 +V.1($-3 3(.- #$2 !1 -"'$2 2.-3 1?&+?$2 #$ % =.- : ".-31$1 + 5$12(.-
,.+ (1$S++$$2343(+(2?$".,,$ -"1 &$+.1204$+ %.1"$#?+(51?$-$#?/ 22$/ 2hdd&
\2(-.-+V$%%$3#$5($-3.13'./?#(04$]S
$#(2/.2(3(%#?/$-#$-3(>1$,$-3#$+ "../?1 3(.-#4/ 3($-3S
lf
III.2.2.3. Comparaison de l’ancrage en technique Edgewise et
Bioprogressive dans les traitements orthodontiques de classe II par
tractions intermaxillaires
-$ ?34#$ ".,/ 1 3(5$ #$ +V -"1 &$P $- 3$"'-(04$ (./1.&1$22(5$ $3 $- 3$"'-(04$
#&$6(2$23 -# 1## -2+$231 (3$,$-32#$"+ 22$
04(.-3?3?31 (3?$2
5$"24"">2/ 1#$2?+ 23(04$2#$"+ 22$
S
$/1$,($1&1.4/$/.22?# (34- 1"#$! 2$P(-#(04?/.41.!3$-(14- -"1 &$".13(" + 4
-(5$ 4#$+V 1" #$, -#(!4+ (1$ 5 -3+ ,(2$$-/+ "$#$2
#$"+ 22$
S
$2$".-#
&1.4/$ ?3?31 (3?$-3$"'-(04$#&$6(2$23 -# 1#.F+ /1?/ 1 3(.-#V -"1 &$,$3$-
/+ "$ 4- // 1$(+ ,4+3(! &4$ ".-3(-4P $3 4- 1" 1$"3 -&4+ (1$ W(#? +X 241 4-$ 1" #$
, -#(!4+ (1$!($- +(&-?$S
$2&1.4/$2?3 ($-32?+$"3(.--?2$-%.-"3(.-#$+V;&$P#42$7$
$3#$+ 04 -3(3?#$/.13#$2
#$"+ 22$
S
$2 - +82$2 "?/' +.,?31(04$2 241 3?+?1 #(.&1 /'($2 #$ /1.%(+ /1?T $3 /.23T31 (3$,$-3
.-3 ?3? ".,/ 1?$2 / 1 24/$1/.2(3(.-P %(- #$ ,$331$ $- ?5(#$-"$ +$2 "' -&$,$-32
#$-3 (1$2, -#(!4+ (1$2P+(-? (1$2$3 -&4+ (1$2S
$ 3$23 23 3(23(04$ \3T3$23] 1?5?+? +V !2$-"$ #$ #(%%?1$-"$2 2(&-(%(" 3(5$2S
$2 ,.+ (1$2
, -#(!4+ (1$2 .-3 ?&1$22? $3 2$ 2.-3 ,?2( +?$2 #$ % =.- (#$-3(04$ # -2 +$2 #$47
&1.4/$2S$,@,$P+ 5$23(!4+.T5$12(.-#$2(-"(2(5$2, -#(!4+ (1$2?3 (3?& +$S
($-04$+V -"1 &$".13(" +-V (3/ 21$3 1#?+$,.45$,$-3#$2,.+ (1$2, -#(!4+ (1$2P
(+ -V$- ?3 (3 / 2 ,.(-2 422( $%%(" "$ # -2 +$ ".-31E+$ #4 ,.45$,$-3 ,.+ (1$ 04$
+V // 1$(+,4+3(! &4$".-3(-4$-3$"'-(04$#&$6(2$S
lg
(-2(P "$33$ ?34#$ ,.-31$ 4-$ !2$-"$ #$ #(%%?1$-"$ 2(&-(%(" 3(5$ $-31$ +$ ".-31E+$ #$
+V -"1 &$ $- 3$"'-(04$ (./1.&1$22(5$ $3 $- 3$"'-(04$ #&$6(2$ 23 -# 1# +.12 #4
31 (3$,$-3#$+ "+ 22$
lh
"'(141&(" + /.41 #(,(-4$1 "$33$ .23?.T(-3?&1 3(.- $3 4&,$-3$1 +$41 1?2(23 -"$
,?" -(04$Q
-
$41 .23?.(-3?&1 3(.- -V$23 / 2 -?"$22 (1$P (+ 2V &(3 /1(-"(/ +$,$-3 #V4-$ %(!1.T
(-3?&1 3(.-\lh]S
$3 47#V.23?.T(-3?&1 3(.-5 1($$-%.-"3(.-#$2?34#$2$3#$2
/ 3($-32\eek]P$32V ""1.B3 5$"+$3$,/2S
$2?34#$2'(23.+.&(04$2,.-31$-34-$
#$-2(%(" 3(.-.22$42$ 43.41#$+ 5(2 /1>22 ,(2$$-"' 1&$$32.-43(+(2 3(.-
"+(-(04$ \eel]S
23 !(+(3? $23 #.-" 2241?$ $- &1 -#$ / 13($ / 1 +V -"1 &$
,?" -(04$# -2+V.2P#V.F+V(,/.13 -"$#$+ 23 !(+(3?/1(, (1$Q
- $ % (3P + ,(2$ $- "' 1&$ #$ + 5(2 /$43 @31$ (,,?#( 3$ \eel]P +$ ).41 ,@,$ .4
31>21 /(#$,$-3 5$"#$2%.1"$2+?&>1$2\id&].4 /1>2"(" 31(2 3(.-,404$42$
\eem]Q
- -%(-P+$41".G3$23,.#?1?S
)'52%[^J.#2!'%$)2%#40!2-).)6)3RVWUS
li
-
M!.#2!'% ).$)2%#4 J 43(+(2 3(.- #$2 ,(-(5(2 ".,,$ 1$-%.13 #V -"1 &$
#$-3 (1$/1?$7(23 -3S
%.1"$$23 //+(04?$2414-$#$-3.44-&1.4/$
#$#$-3223 !(+(2?2/ 1+$41+( (2.-:+ ,(-(5(2\(&41$kd]S
)'52%\UJ.#2!'%).$)2%#40!2-).)6)3RVWUS
.#2!'%0!2-).)6)3$52!.4,!02>0!2!4)/.$M!.#2!'%$%
L
,/23$50/24$%3
$%#,!33%
o -3$"'-(04$#(1$"3$R
$2 ,(-(5(2P /+ "?$2 /.23?1($41$,$-3P 2.-3 +$2 /.(-32 #V //+(" 3(.- , 7(++ (1$2 #$2
?+ 23(04$2 #$ "+ 22$
$3 ?5(3$-3 + 2.++("(3 3(.- #$2 ,.+ (1$2 , 7(++ (1$2P $3 / 1
".-2?04$-3+V$,/+.(#$\(&41$ke]S
)'52%\VJ.#2!'%$)2%#40!2-).)6)3-!8),,!)2%,/23$%,!02>0!2!4)/.
$T!.#2!'%0!2
$%#,!33%
R#/524/)3)%$52
S
lj
o -3$"'-(04$(-#(1$"3$R
$2 ,(-(5(2 2241$-3 +$ ".-31E+$ #$2 ,.+ (1$2 , 7(++ (1$2 $- 2$ 24!23(34 -3 4
\efe]P$++$22.-3/+ "?$2/1."'$2#$2,.+ (1$2, 7(++ (1$22.43$- -3+$2?+ 23(04$2
#$"+ 22$
)'52%\WJ2!)4%-%.4$%#,!33%
R!6%#%842!#4)/.$%02>-/,!)2%3SJ!.#2!'%-/,!)2%).$)2%#40!2
-).)6)3,/23$50/24$%3
$%#,!33%
%4&%2-%452%3)-5,4!.>%$%3$)!34=-%3R^YS
).)6)3#/.42@,!.4,!6%34)"5,/L6%23)/.$%3).#)3)6%3
-!.$)"5,!)2%3$52!.4,%0/24$%3
$%#,!33%
++$22.-3 +.12/.2(3(.--?$2:+V 1" #$, -#(!4+ (1$$31$+(?$2 47#$-32 -3?1($41$2/ 1
#$2#(2/.2(3(%2(-31 T 1" #$2\(&41$kg]S
lk
)'52%\XJ/.42@,%$%,!6%34)"5,/L6%23)/.$%,T).#)3)6%-!.$)"5,!)2%0%.$!.4,%0/24$%3
$%#,!33%
0!2-).)6)3J).()")4)/.$%,!#/-0/3!.4%->3)!,!.4%$%3
$%#,!33%
!5.)6%!5$%3-/,!)2%3-!.$)"5,!)2%3$M!005)R
%4SRVWWS
$2 -"1 &$2204$+$33(04$22.-3#.-",.(-2$-".,!1 -32P/+42$23'?3(04$2P/+42
".-%.13 !+$2 $3 ,($47 3.+?1?2 / 1 +$2 / 3($-32 04$ +$2 1$-%.132 #V -"1 &$ 31 #(3(.--$+2
$,/+.8?2$-3$"'-(04$#$T
.4$-3$"'-(04$(./1.&1$22(5$S
$/$-# -3P +$2 ,(-(5(2 /$45$-3 /1?2$-3$1 #$2 ".,/+(" 3(.-2 -.3 ,,$-3 +.12 #$
+$41 ,(2$ $- /+ "$ \#.4+$41P 14/341$P , -04$ #$ 23 !(+(3?] .4 +.12 #$ +$41 43(+(2 3(.-
\/1.+(%?1 3(.-,404$42$P!+$2241$2P,.!(+(3?,?#( 3$P2$-2(!(+(3?:+ , 23(" 3(.-]\eek]S
++$2 /1?2$-3$-3 ?& +$,$-3 #$2 ".-31$T(-#(" 3(.-2 !2.+4$ .4 1$+ 3(5$2 +(?$2 : +V?3 3 #$
2 -3?&?-?1 +".,,$3.43$"'(141&($/ 1.#.-3 +$S
$/+42P4-$,?3 T - +82$,$-?$/ 1
% (3?3 3#V4-3 47#V?"'$"/ 1
%1 "341$.4/ 1/$13$#$23 !(+(3?#$ejPhp\efg]S
++$2 2.-3 #.-" 1?2$15?$2 /+42 / 13("4+(>1$,$-3 47 #4+3$2P 47 #.+$2"$-32 /$4
"../?1 -32 $3 # -2 3.42 +$2 " 2 .F +V -"1 &$ 31 #(3(.--$+ +5?.+.T#$-3 (1$ -V$23 / 2
24%%(2 -3/.411?/.-#1$ 47.!)$"3(%2#$31 (3$,$-32S
ll
/.2(3(.-#$+V(-"(2(5$, -#(!4+ (1$$23".-2(#?1?$/ 1+ /+4/ 13#$2 43$412".,,$
4- "1(3>1$ #?"(2(% #4 /+ - #$ 31 (3$,$-3 $3 4- .!)$"3(% #$ %(-(3(.- & 1 -3 #$ + 23 !(+(3?
.""+42 +$S
.- /.2(3(.--$,$-3 (#? + -.3 ,,$-3 ?3? #?"1(3 4 31 5$12 #V - +82$2 "?/' +.T
,?31(04$22$! 2 -3241#$21$/>1$2"1;-($-2\P
]P#$-3 (1$2\
]
.4$-".1$"43 -?2\
]S
.43$%.(2P + ,(2$ $- /+ "$ #V4-$ ,?" -(04$ #$ "+ 22$
/.422? +$2
.13'.#.-3(23$2 : ! -#.--? "$33$ 3$"'-(04$ #V -"1 &$S
+ $- $23 #$ ,@,$
/.41W+V -"1 &$".13(" +X#?"1(3/ 1
P#.-3+V$%%(" "(3?-V / 2?3?#?,.-31?$S
lm
?2.1, (2P $- /1 3(04$ .13'.#.-3(04$P + ,?" -(04$ #$ "+ 22$
/ 1
24"">#$
#(1$"3$,$-3 47 /' 2$2 #V +(&-$,$-3T-(5$++$,$-3 2 -2 31 5 (+ /1? + !+$ #V -"1 &$
, -#(!4+ (1$S
4V$-$23T(+#4".-31E+$#$+ /.2(3(.-#$+V(-"(2(5$, -#(!4+ (1$U
+ #?/$-# #$ "1(3>1$2 &?-?1 47 +(?2 4 /1 3("($- \3$"'-(04$ /1?".-(2?$ R $731 "3(.-2 #$
/1?,.+ (1$2P 231(//(-& $3 3.104$ ".1.-.T+(-&4 +P .4 $-".1$ 43(+(2 3(.- #$ ,(-(5(2]P 4
/ 3($-3 \;&$P "../?1 3(.-]P $3 #$ "1(3>1$2 +." 47 \/.22(!(+(3? #$ 5$23(!4+$1 +V(-"(2(5$
, -#(!4+ (1$]S
$/$-# -3P+V(,/.13 -"$#V 431$2% "3$412(-%+4$-= -3+ 5$23(!4+.T5$12(.-#$+V(-"(2(5$
, -#(!4+ (1$$-1? "3(.- 47
P-.3 ,,$-3+ 38/.+.&($P+V(,/.13 -"$#$+ "+ 22$
(-(3( +$\/ 13($++$.43.3 +$]$3+ #41?$#$/.13#$2?+ 23(04$2P-V / 2?3?/1?"(2?,$-3
#?%(-($SV$23/.4104.(+V?+ !.1 3(.-#V4-$?34#$#$" 2"+(-(04$2$23$-".412# -2
+V4-(3?#V$-2$(&-$,$-3#V.13'./?#($#$-3.T% "( +$#4 (-3T."':("$S
S
md
(&41$eR
++4231 3(.-#$+ "+ 22$
#(5(2(.-eSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSl
(&41$fR
++4231 3(.-#$+ "+ 22$
#(5(2(.-fSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSl
(&41$gR
V -&+$1$/1?2$-3$+$#?" + &$204$+$33(04$, 7(++.T, -#(!4+ (1$2$+.-
SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSm
(&41$hR
++4231 3(.-#$+V(-%+4$-"$#4/1.&- 3'(2,$% "( +241+V -&+$RSSSSSSSSSSSSSSSSSSSSSSSm
(&41$iR$/1?2$-3 3(.-#$+V(-#("$#$(32#$\i]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSed
(&41$jR1 "3(.-(-3$1, 7(++ (1$#$"+ 22$
\/.2(3(.--$,$-3+$/+42".41 -3]SSSSSSSSSSSSSeh
(&41$kR%%$32#$2
#$"+ 22$
$-.""+42(.-SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSek
(&41$mR.2(3(.-#$2"$-31$2#$1?2(23 -"$#$2 1" #$2#$-3 (1$2\ej]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSel
(&41$edR.,/ 1 (2.-#$+V$%%$3#$! 2"4+$#4/+ -#V.""+42(.-$-31$+$2
#$"+ 22$
me
(&41$fdR'.3.&1 /'($2(-(3( +$2,.-31 -3:& 4"'$+ %1 "341$#4%(+#$".-3$-3(.-
$-31$hf$3hgP$3:#1.(3$+ 1?"$22(.-&(-&(5 +$$-1$& 1##$+ gf\gl]SSSSSSSSSSSSSSSSSSSSSgd
(&41$feR(-(3( +SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSgd
(&41$ffR?" -(04$2$&,$-3?$ 5$"%(+$-1$+(?:+ gf$3 47,.+ (1$23 -#(204$
+a 1" #$$2323 !(+(2?$/ 14-%(+/ 22(%$- "($1\gl]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSge
(&41$fgR'.3.&1 /'($2(-31 T.1 +$2 5 -3\:& 4"'$]$3 /1>231 (3$,$-3\:#1.(3$]Sge
(&41$fhR/.23T31 (3$,$-3#$+V(-"(2(5$+ 3?1 +$, -#(!4+ (1$& 4"'$P 5$"4-$
54$2 &(33 +$$3".1.- +$#43($12 /(" +,.-31 -3+a.2 4-(5$ 4#$2,412+(-&4 +$3
,?2( +#$+ 1 "(-$\gl]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSgf
(&41$fiR
a 4&,$-3 3(.-#$+a$7/.2(3(.-#$2(-"(2(5$2, -#(!4+ (1$2 5$"+a;&$\hd]gg
(&41$fjR4$2$-#.!4"" +$2$3$7.!4"" +$2+.12#$+ /'.- 3(.-241+$WX#$
W,, XP 5 -3$3 /1>2-(5$++$,$-3.13'.#.-3(04$\hd]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSgg
(&41$fkR
,/ "3#$+V(-"+(- (2.-#$2(-"(2(5$2241+ &?-(./+ 23($#$/1./4+2(.-P
/.22(!(+(3?#$" ,.4%+ &$#$+ 5$23(!4+.5$12(.-#$2(-"(2(5$2(-%?1($41$2/ 1+
&?-(./+ 23($, (2$%%$3( 31.&>-$241+$
\hg]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSgh
(&41$flR(-0$7$,/+$2#$#?3$1,(- 3(.-#$+ /.2(3(.-#$+V(-"(2(5$, -#(!4+ (1$
2$+.-+$2 - +82$2"?/' +.,?31(04$243(+(2?$2\hh]R12"$&% $".
-12"$&% %"-12"$&% -12
"$&(/"$"-12"$&(#$*$!%
SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSgi
(&41$fmR1( -&+$% "( +#$6$$#\hk]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSgj
(&41$gdR.1,4+$#$\gl]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSgk
(&41$geR 1,.-($% "( +$#?%(-($/ 1+V -&+$%.1,?$-31$+ +(&-$$3+$/+ -#$
1 -"%.13\hi]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSgl
(&41$gfR//$1+(/$33.3 +"'(-\hl]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSgm
(&41$ggR-$5 +$41#$(3.24/?1($41$:h,,?5.04$4-$/1.T +5?.+($#$
+V(-"(2(5$, -#(!4+ (1$P4-$5 +$41#$(3.24/?1($41$:fiu?5.04$4-$
5$23(!4+.T5$12(.-#$+V(-"(2(5$, -#(!4+ (1$SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSShd
(&41$ghR
1>&+$#V
\ih]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSShe
(&41$giR
$"'$51.-#$
SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSShf
(&41$gjR$241$#$+a$2/ "$#(2/.-(!+$\]:& 4"'$$3#$+V$2/ "$-?"$22 (1$\]:
#1.(3$SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSShg
(&41$gkR1.%.-#$41#$+ ".41!$#$/$$\ii]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSShh
mf
(&41$glR' 13$#$
13($24/?1($41$R"'$51.-2(#? 47\W".,/1.,(2
""$/3 !+$2X]2$+.-+V -&+$SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSShi
(&41$gmR+ -#$-3 (1$T.&SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSShj
(&41$hdR.2(3(.-#$+a(-"(2(5$, -#(!4+ (1$2$+.-
\jj]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSShk
(&41$heR
-%+4$-"$#V4-$/1., 7(++($.4#V4-$1?31., -#(!4+($241+$2,$241$2:
/ 13(1#4/+ -T.&R+ /1., 7(++($#(,(-4$+$25 +$4123 -#(204$+
1?31., -#(!4+($.4+V.45$1341$#$+V -&+$, -#(!4+ (1$+$2 4&,$-3$-3SSSSSSSSSSSSSSSSSSSShl
(&41$hfR
V -&+$
?3 -3$-3(>1$,$-3".-%(-?:+V(-3?1($41#$+ , -#(!4+$-V$23P
+4(P/ 2 %%$"3?/ 1+$2"' -&$,$-32204$+$33(04$2SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSShl
(&41$hgR
++4231 3(.-#43.104$ "3(%$3/ 22(%SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSig
(&41$hhR.104$4-(%.1,$/ 1".41!41$241+$"' -3#V4- 1"1$"3 -&4+ (1$$-#$47
/.(-32SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSih
(&41$hiR.-31E+$#43.104$/ 1+$"341$#V4-$ 33 "'$/1?T(-%.1,?$# -2+$g>,$.1#1$
\ ].4/ 13.12(.-241"' -3#V4- 1"#$2$"3(.-1$"3 -&4+ (1$ 5 -32.-(-2$13(.-
# -2+a 33 "'$\!]\jj]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSii
(&41$hjR
-"+(- (2.-(#? +$#$+a(-"(2(5$, -#(!4+ (1$2$+.-
SSSSSSSSSSSSSSSSSSSSSSSSSSSSij
(&41$hkR1(-"(/$#a "3(.-Y1? "3(.-\ede]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSik
(&41$hlR
++4231 3(.-#a4-$1 "(-$,.+ (1$$,!1 22 -3+$" - +, -#(!4+ (1$\km]SSSSSjd
(&41$hmR41% "$21 #("4+ (1$2\,,n]#a /1>2(-
\jj]SSSSSSSSSSSSSSSSjd
(&41$idR +$412&4(#$2#a -"1 &$2$+.-(-
\jj]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSje
(&41$ieR.+4,$21 #("4+ (1$2$3".$%%("($-32#a -"1 &$2$+.-
\lj]SSSSSSSje
(&41$ifR
++4231 3(.-#$2#$47/1(-"(/ 47,42"+$2, 23(" 3$412\3$,/.1 +$3
, 22?3$1]\lk]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSjg
(&41$igR
(&-$2#$+V - +82$#$
\h]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSjh
(&41$ihR.4/$%1.-3 +$#V4-.2, -#(!4+ (1$2$",.-31 -3+V.2".13(" +".,/ "3$-
/?1(/'?1($$3+V.2 +5?.+ (1$2/.-&($47 4"$-31$SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSji
(&41$iiR04(+(!1$#4W 28,?31(04$X" 42?/ 1+$3(/! "*SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSjk
(&41$ijR1 "3(.-(-3$1, 7(++ (1$#$"+ 22$
SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSjl
(&41$ikR
++4231 3(.-#$+ %.1"$$731 T.1 +$:31 "3(.-' 43$/ 1
\mi]$3
2.-$%%$3241+ ,.+ (1$, 7(++ (1$/.41".-31$1"$47#$2
#$"+ 22$
SSSSSSSSSSSSSSSSkd
(&41$ilR
++4231 3(.-#V4- / 1
\mi]$32$2$%%$32+.12#$+
/1?/ 1 3(.-#V -"1 &$\2 -22.++("(3 3(.-, 7(++ (1$]\mk]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSkd
(&41$imR3 !(+(2 3(.-#$+ /1?/ 1 3(.-#a -"1 &$, -#(!4+ (1$SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSkf
mg
(&41$jdR
,?" -(04$#$"+ 22$
2$+.-T
SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSkg
(&41$jeR4/$1/.2(3(.-+." +$\(T, 5$",$-1$&(231?]R?5 +4 3(.-#$2
,.45$,$-32(-"(2(%2$3,.+ (1$2\edePedf]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSki
(&41$jfR1?2$-3 3(.-#$+V 1"#$! 2$SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSkl
(&41$jgR"3(5 3(.-/.23?1($41$#$+V 1"#$! 2$R+.12#$2.-(-2$13(.-# -2+$234!$2
,.+ (1$2P+ / 13($ -3?1($41$#$+V 1"/+.-&$# -2+$5$23(!4+$P1$5$+ -3+V "3(.-
(-&1$22 -3$#4#(2/.2(3(%\mm]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSkm
(&41$jhR"3(5 3(.-2#$+V 1"#$! 2$P 5$":& 4"'$+$2$%%$32#43(/T! "*,.+ (1$$3:
#1.(3$"$47#43.104$(-"(2(5$".1.-.T+(-&4 +SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSkm
(&41$jiR1"#$! 2$ 5$"+V "3(.-".,!(-?$#43(/T! "*,.+ (1$$3#43.104$".1.-.T
+(-&4 +(-"(2(%R+$2$%%$322a ).43$-3P&?-?1 -3#$47".4/+$2#$%.1"$2#$,@,$2$-2P
(-2(04$#$2%.1"$2?&1$22(5$2/.23?1($41$2$3(-&1$22(5$2 -3?1($41$2SSSSSSSSSSSSSSSSSSSSSSld
(&41$jjR1"+(-&4 +\jj]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSld
(&41$jkR1?2$-3 3(.-$3$%%$32#4/ 1$T"'."2+ !( +\eed]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSle
(&41$jlR.-31E+$#$+ ,.+ (1$, -#(!4+ (1$/ 1+$/ 1$T"'."2+ !( ++.12#$
+V //+(" 3(.-#$
#$"+ 22$
\eed]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSlf
(&41$jmR-"1 &$#(1$"3/ 1,(-(5(2\efd]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSli
(&41$kdR-"1 &$(-#(1$"3/ 1,(-(5(2\efd]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSlj
(&41$keR-"1 &$#(1$"3/ 1,(-(5(2, 7(++ (1$+.12#$+ /1?/ 1 3(.-#a -"1 &$/ 1
#$"+ 22$
\".413.(2($#41
]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSlj
(&41$kfR1 (3$,$-3#$"+ 22$
$3%$1,$341$2(,4+3 -?$#$2
#( 23>,$2\mh]SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSlk
(&41$kgR.-31E+$#$+ 5$23(!4+.T5$12(.-#$+a(-"(2(5$, -#(!4+ (1$/$-# -3+$/.13
#$2
#$"+ 22$
mh
eS + 5("$*P"' #+! 4$1P"'1 -&+P "* S
$21 //.132204$+$33(04$2$3+
".,/$-2 3(.-#$-3.T +5?.+ (1$S$513'./?#($$-3.T "( +$S."3emlgQek\h]RhmgiejS
fS " , 1 S.,/.-$-32.%"+ 22
$+ 23("26(3'
-.-$731 "3(.-2$&,$-3 +3$"'-(04$2S-&+$13'.#S)4(++fddkQkk\h]RjmhkddS
ehS $(231$++P -&( +.2(P
./$9P !1 +T-&$+$2S"$/' +.,$31(" //1 (2 +
mi
.%-.-$731 "3(.-$&&31$ 3,$-3.%+ 22
, +.""+42(.-6(3'+ 22
".11$"3(.-6(3'
(-3$1, 7(++ 18$+ 23("%.1"$S,13'.#$-3.% "( +13'./Se."3emmlQeeh\h]RhgdjS
elS 13(- P4" P.22(
P$11.S
-%+4$-"$#$231 "3(.-2?+ 23(04$2
(-3$1, 7(++ (1$2241+$22314"341$2#$-3 (1$2$3204$+$33(04$2# -2+$31 (3$,$-3#$2
+ 22$2
, +.""+42(.-".11$"3(.- %3$131$ 3,$-36(3'+ 22
$+ 23("2.1%(7$#%4-"3(.- +
//+( -"$2S,13'.#$-3.% "13'./%%4!+,22."13'.#
32.-23.",
. 1#13'.#S."3fddkQegf\h]RhmmidgS
fdS 42'%.13'P.1#.- P(1#S*$+$3 + -##$-3 +"' -&$2%.++.6(-&3'$42$
.%3'$1 -*$+%4-"3(.- +1$&4+ 3.1S113'.#S)4(-emmmQfj\f]RefkghS
feS (
P .P' -&P -&P' -&S.,/ 1(2.-.%3$,/.1., -#(!4+ 1).(-3
"' -&$2(- #.+$2"$-3+ 22
31$ 3,$-3S-&+$13'.#S2$/3fddlQkl\i]RleglS
fgS
431.4S%%$32#$5$12(.-#$2(-"(2(5$2# -2+$31 (3$,$-3#$+ "+ 22$
P
#(5(2(.-eP/ 1 "3(5 3$41,.-.!+."1(&(#$ 22."(?:4-$%.1"$$731 T.1 +$vR/.22(!(+(3?2
#$".-31E+$S$513'./?#($$-3.T "( +$S#?"fddgQgk\h]RgkkmgS
fhS 1"'?T$81 3S
$2+(,(3$2#$+ #$-341$, -#(!4+ (1$S$513'./?#($$-3.T
"( +$S 51emliQem\f]ReiejhS
fiS '(+(//$S$+ /.2(3(.-#$2(-"(2(5$2S$513'./?#($$-3.T "( +$S."3
emkgQk\h]RhhmjjS
fjS S13'./?#($#$-3.T% "( +$S 1(2R#S#QemkdSgmd/S
mj
fkS ("*$332S4-"3(.- +#( &-.2(2.%, +.""+42(.-S1 -24113'.#."S
emilQefeS
flS 4%%$1P$5(-"$-9.P.1!$33P'18."*S$+ 3(.-2'(/!$36$$-3'$
(-&4 +.%3'$ 7(++ 18$-31 +
-"(2.1 -#3'$13("4+ 1,(-$-"$(-
#$ +""+42(.-2S
-&+$13'.#Se) -5emkfQhf\e]RhhmS
fmS .22T 22 ++(
P1$!$-23$(-P./.49$+(2P"4+$ -P 32 1.2S13'.#.-3("
3'$1 /8 -#&(-&(5 +1$"$22(.-R 2823$, 3("1$5($6S13'.#1 -(.% "$2S .G3
fdedQeg\g]RefkheS
gdS 9(9P+.1$2T(1S2823$, 3("1$5($6.%3'$ 22."( 3(.-!$36$$- //+( -"$T
(-#4"$#+ !( +,.5$,$-3.%, -#(!4+ 1(-"(2.12 -#&(-&(5 +1$"$22(.-S42313'.#S
, (fdeeQfk\e]RggmS
geS $-*$, P4# +$)P$-*$, P1.-*'.123P 32 1.2S(-&(5 +
1$"$22(.-2 -#3'$"' -&$.%(-"+(- 3(.-.%, -#(!4+ 1(-"(2.12#41(-&.13'.#.-3("
31$ 3,$-3S4113'.#S 51fdegQgi\f]RfhmiiS
gfS , *P , * P$*+(* P41$+ S'$%%$"3.%' -&$2(-
.6$1
-"(2.1
mk
hdS 4++$1S7/.2(3(.-#$2(-"(2(5$2, -#(!4+ (1$2"'$9+$2$-(.1vR //+(" 3(.-2
.13'.#.-3(04$2S$513'./?#($$-3.T "( +$S) -5fdegQhk\e]RfmgmS
heS #$S'$1.+$.%3'$, -#(!4+ 1 -3$1(.13$$3'(-".,/+$3$#$-341$$23'$3("2S
1.23'$3$-3S."3emkmQhf\h]RgjlkdS
hfS !$1(-S1(3>1$2#$1?422(3$$23'?3(04$#$2&?-(./+ 23($2S$23'$3("4""$22
$-(./+ 23($21."$#1(3$1( S)4(-fdejQlk\f]RemefdgS
hgS $2'/ -#$P4-.+(S22$.42&$-(./+ 238R" 2$2$1($2S
-#( -+ 2341&S
fdeeQhh\g]RhehS
hhS "'4+'.%P++$-S'$, -#(!4+ 1#$-3 + 1"'R 13
P+.6$1(-"(2.1/.2(3(.-ST
-&+$13'.#S"3emkkQhk\h]RfldTkS
hiS 4,(31 "'$P313"'(-$S1.(2 - +82$2"?/ ' +.,?31(04$2424$++$2ST
$#4"" +$SfdegQl\h]S
hjS 6$$# S'$1 -*%.13T -#(!4+ 1
-"(2.1-&+$\
]
-13'.#.-3("
( &-.2(2P1$ 3,$-3+ --(-& -#1.&-.2(2S-&+$13'.#Se)4(++emihQfh\g]RefejmS
hkS 6$$# S+(-(" +13'.#.-3("2S.2!8QemjjShil/S
hlS $11(%($+#
S'$/1.%(+$+(-$ 2 - (#(-"1(3(" ++8$5 +4 3(-&% "( +$23'$3("2S,
13'.#Se-.5emjjQif\ee]RldhffS
hmS
.1$(++$TP$+ (1$P (++ 1#P 1 9(-S?/' +.,?31($$3.13'.#.-3($S 1(2P
1 -"$R#(3(.-2SSSSQemmfSgej/S
idS 4++$1
P
.1$(++$TP$+ (1$P 1 9(-S?/' +.,?31($$3.13'.#.-3($SQ
emlgSgfd/S
ieS 3$(-$1S$/' +.,$31("2%.18.4 -#,$S,13'.#SemigQgmRkfmiiS
ifS 3$(-$1S$/' +.,$31("2
-+(-(" +1 "3("$S-&+$13'.#Se) -5
emimQfm\e]RlfmS
igS '.,S$73!..*.%1 + #(.+.&8S+2$5($1
-#( QfddmSkdj/S
ihS .+# 6 8S2.%3T3(224$"$/' +.,$31(" - +82(2 -#(3242$(-.13'.#.-3("
31$ 3,$-3/+ --(-&S 13
-3.4-#S 51emliQegRjikfS
ml
ilS 4&.-(S.,/1$'$-2(5$,(7$##$-3(3(.-31$ 3,$-3S,13'.#$-3.% "
13'./%%4!+,22."13'.#
32.-23.",. 1#13'.#S) -5
emmlQeeg\e]RkilhS
imS .6-2PSS- +82(2.%3'$#$-3.% "( +/1.%(+$S-&+$13'.#S
emijQ\fj]RemefefS
jdS .6-2PSS 1( 3(.-2(-% "( +1$+ 3(.-2'(/2R'$(12(&-(%(" -"$(-31$ 3,$-3 -#
/1.&-.2(2T,$1(" -.41- +.%13'.#.-3("2S,13'.#SemhlQ\gh]RlefhdS
jeS ("*$332S'$*$823.-$31( #
mm
+(& 3(-&!1 "*$32S,13'.#$-3.% "13'./%%4!+,22."13'.#
32.-23."
,. 1#13'.#S, (fddlQegg\i]RkfelS
kiS 1$$*,.1$S-3.104$S+(-13'.#S, (emkmQeg\i]RgdiedS
kjS $!$"*S".,/ 1(2.-.%3'$$%%$"32.%+ 22
-#$-T6.,$"' -("2.-3'$
, -#(!4+ 1(-"(2.1S' 1+$2 6$$#
-3.4-#S 51emlgQeeRedieiS
kkS
$).8$47P+ &$4+S'?1 /$43(04$.13'.#.-3(04$vR
.&(04$$3".'?1$-"$S 1(2Q
.-#1$2Q$1+(-$3"SR4(-3$22$-"$
-3$1- 3(.- +QfdeiSelh/S
klS 1.%%(3P1 P 15$1S.-3$,/.1 1813'.#.-3("2S+2$5($1 $ +3'
"($-"$2QfdehSejgi/S
kmS S..3241% "$ 1$ 1$+ 3$#3. -"'.1 &$(-3'$$&&$"'-(04$S
^$,/'(2_QemjiS
ldS (-2*$1
S'$ 1 ! * //+( -"$S
-313'.#S)4(++emjkQi\f]RhiimS
leS 4123.-$S 3(.- +$.%3'$2$&,$-3$# 1"'S,13'.#Se-.5
emjfQhl\ee]RldiffS
lfS 4123.-$P.$-(& S/3(,(9(-& -3$1(.1 -#" -(-$1$31 "3(.-S,13'.#S
)4(++emkjQkd\e]ReemS
lgS ("*$332S'$6(2#.,.%3'$!(./1.&1$22(5$/'(+.2./'8S$,(-13'.#S#?"
emmlQh\h]RfdemS
lhS 22(&-8P 3"'$1$ -T !1($+'(++>2P$1- 1#4,.4+(-P /' A+(+(//(P
("'$+
$ ++P
?.- 1#. 3.22( -P
41$-3S.45$++$2".-"$/3(.-#$+V -"1 &$$-
.13'.#.-3($T#(3(.-2#S
-(3( 3(5$2 -3$QfdeiSfmf/S
liS "(3?/ 1
S S+(-(" +$7 ,(- 3(.-(-#$-3.% "( +
.13'./$#("2 -#(-.13'.#.-3("2%.142$!83'$&$-$1 +/1 "3(3(.-$1S
-%$-3Sfe2$/3
emklQjd\gl]Rhihm".-"+S
ljS +T !!.43S
V //.13#42" --$1g$- - 3.,($#$-3 (1$vR1?24+3 32$3
//+(" 3(.-2 47" +"4+2#V -"1 &$$3:+ ,?" -(04$.13'.#.-3(04$S-(5$12(3?.4+.42$
edd
mdS 4&(-.S$"'-(04$#$("*$332S$513'./?#($$-3.T "( +$S) -5
emkhQl\e]RedkeeS
meS
S +.""+42(.-#438/$"+ 22$
#a-&+$R?34#$/(+.3$#a4-$
+3$1- 3(5$#$31 (3$,$-3Sfddi 22 &$2#$ 1(2ehlTejiS
mfS .411( 4P .1-P13( +PSS1?/ 1 3(.-#V -"1 &$$3,?" -(04$#$"+ 22$
S
#&$SemlfQjRkkeekS
mgS S1?/ 1 3(.-#V -"1 &$$3"../?1 3(.-,(-(,4,S#&$6(2$S
emlkQejRifhS
mhS C,S?".,/$-2 3(.-#V4-$/1. +5?.+($, -#(!4+ (1$/ 1 -"1 &$,(-(T5(2
, 7(++ (1$# -2+$31 (3$,$-3#V4-$"+ 22$
P#(5(2(.-e#V-&+$S13'.#1S#?"
fdeeQlf\h]RghejS
miS $11(%($+#
P1.22S(1$"3(.- +%.1"$2S,13'.#Se, (emkdQik\i]RhgijhS
mjS +.-39 S6$$#T$11(%($+#2$04$-3( +#(1$"3(.- +%.1"$31$ 3,$-3S$,(-
13'.#Se#?"emmjQf\h]RfihjkS
mkS $".22$P .1-S.-31E+$"?/' +.,?31(04$$3#(,$-2(.-5$13(" +$S
ede
edlS
$).8$47P+ &4$4+S1./.2(3(.-2.13'.#.-3(04$2"+ 22$
S(34 3(.-2"1(3(04$2
T#(3'
$).8$47P1 -=.(2$+ &$4+S4(-3$22$-"$
-3$1- 3(.- +$SfdedS
edmS
$).8$47S-$/'(+.2./'($.13'.#.-3(04$S-31$3($- 5$" 1+4&(-.S$5
13'./?#($$-3.T "( +$SemmeQ\fi]RegkhjS
eedS
S.412241+V -"1 &$S
eeeS 4&(-.S-.13'.#.-3("/'(+.2./'8S.+.1 #.U.,,4-(" 3(.-2QemkkS
eefS 4!3$+-8P *4# S42"+$%4-"3(.-P.1 +, +%.1, 3(.-P -#&1.63'"' -&$2S
,13'.#Se)4(++emjjQif\k]RhmiiekS
eegS 3'$1 P 8%($+#P$+2.- S%%$"32.%,42"4+ 1 -"'.1 &$ //+( -"$2.-
#$%("($-3, -#(!4+ 1 1"'+$-&3'S,13'.#Se)4(++emkeQjd\e]RjlklS
eehS .23 P %% (-+P$+2$-S(-(2"1$62 2.13'.#.-3(" -"'.1 &$R
/1$+(,(- 181$/.13S
-3#4+313'.#.-13'.&- 3'41&SemmlQeg\g]RfdemS
eeiS 13'$+$,(P$ 45 + S1?5 +$-"$#$+V43(+(2 3(.-#$2,(-(5(2#V -"1 &$/ 1+$2
.13'.#.-3(23$2%1 -= (2S
-313'.#S#?"fdeiQeg\h]RhgjjeS
eejS $!! 1P.419&4(S-"'.1 &$,(-(2"1$62R'(23.+.&("234#8.%/$1(T(,/+ -3
2.%33(224$S
-313'.#SfdefQlimiS
eekS $4"'T+$231 #$P
$ 1($P$"*$1P4(++ 4,.3S
$2,(-(5(2$-
.13'.#.-3($S
-313'.#SfddmQk\f]ReikjmS
eelS $+2$-S
-#(" 3(.-2#V -"1 &$204$+$33(04$$-.13'.#.-3($S$513'./?#($
$-3.T "( +$S, 12fddjQhd\e]RhejeS
eemS +$'8 -$SP.48 '8 .4(P$-8 '( S(-(T5(2$3 -"1 &$.13'.#.-3(04$vR
,(2$ 4/.(-3S$5#.-3.23., 3.+\ 1(2]SfdeeQ\hd]RfdhfeS
efdS 22(%
P1 /($1
S3(+(2 3(.-"+(-(04$#$2,(-(5(2$-.13'.#.-3($S#.-3.+
$-3.% "( +$SfddjQelS
efeS T P TP TS
V -"1 &$#$2,("1.T(,/+ -32# -2+$2823>,$
#$2%.1"$2#(1$"3(.--$++$2S
-313'.#SfddhQ\f]RegkjeS
effS ++.49$P 104?S(-(T(,/+ -32vR
V.13'.#.-3($#$#$, (-S 1(2R4(-3$22$-"$
(-3$1- 3(.- +QfdefS
efgS "'<39+$P<--"'$-P6 '+$-P
-&S415(5 + -#% (+41$1 3$2.%
.13'.#.-3("3$,/.1 18 -"'.1 &$#$5("$2R 2823$, 3("1$5($6S+(-1 +
,/+ -32$2S
#?"fddmQfd\ef]RegiemS
edf
edg
edh
$18+
#!"$42-57-16-31
La position de l’incisive mandibulaire est considérée par la plupart des auteurs comme un
critère décisif du plan de traitement et un objectif de finition garant de la stabilité occlusale.
Son positionnement idéal a notamment été décrit au travers d’analyses céphalométriques se
basant sur des repères crâniens, dentaires ou encore cutanés.
Cependant, la mise en place d’une mécanique de classe II par tractions intermaxillaires, sans
précaution, entraîne théoriquement un déplacement de l’incisive mandibulaire de par la
composante mésialante de la force qu’ils exercent.
Différentes techniques orthodontiques ont donc été développées pour contrôler les effets des
TIM dont la vestibulo-version excessive de l’incisive mandibulaire. Deux grandes écoles se
distinguent : la « préparation d’ancrage » décrite par TWEED-MERRIFIELD et la
« technique Bioprogressive » de RICKETTS. Tandis que la première préconise une
préparation standardisée de la denture pour tous les patients, la seconde présente une vision
plus individualisée tenant compte de facteurs environnementaux tels que l’équilibre neuro-
musculaire.
edi