[PDF] Pathologies de la muqueuse buccale: identification diagnostic et

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ACADEMIE Nancy-Metz

UNIVERSITE HENRI POINCARE-NANCY 1

FACULTE D"ODONTOLOGIE

Année 2010 N° 3174

THESE pour le

DIPLÔME D"ETAT DE DOCTEUR EN

CHIRURGIE DENTAIRE

par

Caroline ZIMMER

Née le 19 Septembre 1983 à CREUTZWALD (57)

Présentée et soutenue publiquement le

15 janvier 2010

Examinateurs de la Thèse :

Pr. J.P LOUIS Professeur des Universités Président

Dr. Ch. WANG

Maitre de Conférences des Universités Juge Dr. B. PHULPIN Assistant Hospitalier Universitaire Juge Dr. J. BALLY Assistant Hospitalier Universitaire Juge

Dr. P. GANGLOFF

Praticien Hospitalier Juge

LES LESIONS PRECANCEREUSES DE LA

MUQUEUSE BUCCALE. ROLE DE

L"ODONTOLOGISTE : DEPISTAGE ET PRISE EN

CHARGE

Faculté

d'Odontologie Président:ProfesseurJ.P. FINANCEDoyen:Docteur Pierre BRAVETTI MembresHonoraires: Dr.L.BABEL-ProS.DURIVAUX-ProG.JACQUART-ProD.ROZENCWEIG-ProM.VIVIER

DoyenHonoraire: ProJ.VADOT

Sous-section56-01

Mme

Odontologiepédiatrique

M.BOCQUELJulienAssistant

MllePHULPINBérengèreAssistant

M.SABATIER AntoineAssistant

Sous-section56-02Mme

MllePYCatherineAssistant

M.REDONNicolasAssistant

Sous-section56-03

M.

Professeurl

or grade

MmeJ ANTZEN-OSSOLA CarolineAssistant

Sous-section57-01M.

AMBROSINIPascal

ProfesseurdesUniversités'"

i

Parodontologie

M.

MILLERNeal

MaîtredeConférences

M.PENAUDJacquesMaîtredeConférences

M.GALLINASébastienAssistant

M.JOSEPHDavidAssistant

Sous-section57-02

M.

BRAVETTIPierre

MaîtredeConférences

M.

ARTISJean-Paul

Professeur1ergrade

AnesthésiologieetRéanimationM.VIENNET DanielMaîtredeConférences

M.BALLYJulienAssistant

M.CURIENRémiAssistant

MlleSOURDOTAlexandraAssistante

Sous-section57-03

M.

WESTPHALAlain

MaîtredeConférences'"

AssistanteAssociéeau

01/10/2007

Sous-section58-01M.ENGELS-DEUTSCH MarcMaîtredeConférences

OdontologieConservatrice,

Endodontie

M.MORTIEREricMaîtredeConférences

M.

CUNYPierre

Assistant

M.HESSStéphanAssistant

Sous-section58-02M.

SCHOUVERJacgues

MaîtredeConférences

Prothèses(Prothèseconjointe,Prothèseadjointe partielle,

M.DEMARCHPascalMaîtredeConférences

M.BARONESergeAssistant

MlleBEMERJulieAssistante

MlleRIFFAULTAmélieAssistante

MlleMONDON HélèneAssistant

M.SIMONFranckAssistant

Sous-section58-03

Mlle

STRAZIELLECatherine

ProfesseurdesUniversités'"

MmeJAVELOTCécile(Jacquelin)

AssistanteAssociéeau

01/01/2009

souliqné:responsable de lasous-section"'tempspleinMisà jour le01.12.2009

GoPOEoPOCMNDHIOcNRCMHIRMCO

AosoHMOAccNDSAIPDHOHPOPicNDSAIPDHdO

CADEMI ANI anc DMAc AMy a A

E -etzUVRSATVANSeHVzzVRSAPVOtYNORTA1EFnaA E E E EEEEEEEEEEEEEEEEEEMEEEEEEEEEEEEEEEEEEMEEEEEEEEEEEEEEEEEEMEEaCC-D-o*E=o8EèS+0o8E DS=t0-9)o8E

EEEEEEEEEEEEEEEEEEMEEEEEEEEEEEEEEEEEEMEEEEEEEEEEEEEEEEEEMEETo01*oE=oE+C DS=t0-oEISn-YIS+oE=oEA>-*)*D-oENoInS-*oE

E E E *o8èoDnAE E E E E E E E E E E E E E A

CADEMI APFL A MAcnI "M FIAc AMy a A

A E E E l>t*Sèo)n-9)oGE Io8n>t8-Y+YD-oEonEutSI-0Sn-YIE E E E E E E E E E E E E E E E E E E E E E E E A

CADEMI APFL AA

A E E E EEEEEEEEEEEEEEEEEEMEEEEEEEEEEEEEEEEEEMEEEEEEEEEEEEEEEEEEMEE 88-8nSInE>Y8è-nS+-o*E)I-;o*8-nS-*oE E E E E E E ro*;-DoENoInS-*oE=)EAoIn*oE +o<-8EeS)n*-IAE E E E E E E E E E E E E E E E E E E E E

CADEMI APFL AA

A -etzUVRSATVAceGéVRSAPRTUVtA7C11oA E E E EEEEEEEEEEEEEEEEEEMEEEEEEEEEEEEEEEEEEMEEEEEEEEEEEEEEEEEEMEE 88-8nSInE>Y8è-nS+-o*E)I-;o*8-nS-*oE l>t*Sèo)n-9)oGE Io8n>t8-Y+YD-oEonEutSI-0Sn-YIE E E E E E E E E E E E E E E E E E E E E E E E E E E E

CADEMI APFL A MAcnI "M FIAc AMy a A

A -etzUVRSATVAceGéVRSANUVSSVALOt_TeHHA E E E

EoIEA>-*)*D-oENoInS-*oE

EEEEEEEEEEEEEEEEEEMEEEEEEEEEEEEEEEEEEMEEEEEEEEEEEEEEEEEEMEE ID-oIE-Ino*IoEoIEa=YInY+YD-oE

EEEEEEEEEEEEEEEEEEMEEEEEEEEEEEEEEEEEEMEEEEEEEEEEEEEEEEEEMEE ID-oIES88-8nSInE>Y8è-nS+YM)I-;o*8-nS-*oE

A A A A A nt0Y-DIYI8AE A A A A A A A A A A A A A A A A A A A AC C

ANOTR ERP SNAIRDRP

DC C

EMI NancIyNM--------------------------------CeC

IH

ΕEMonsieuirl fMo Jaoirlo esan-lnasMLoMotttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttCzl

CCCAtAlUVMV RSyIVTCHCtttttttttttttttttt-tttttttttttttttttt-ttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttCPl

CCCCCCAtAtAlONMcY1ICaYCSVTyNMCNnCaFRLLYcIyNMC1 VcRMcV YnTYCtttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttC-Pl

CCCCCCCCCCCCCAtAt0t-0l°YC1R1ySSNGR7y nTC4nGRyMC_pourCtttttttttttttttttt-tttttttttttttttttttt-tttttttttttttttttt-tttttttttttCA0l

CCCCCCAtAtÔlpyTINSNéyYCaYCSRCGninYnTYC3nccRSYCMN GRSYCttttttttttttttttttttttttttt-tttttttttttttttttt-ttttttttttttttttCAll

CCCCCCCCCCCCAtAtÔtA-l°FV1yI4VSynGCZV RIyMyTVCtttttttttttttttttt-ttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttCA9l

CCCCCCCCCCCCAtAtÔtD-l°FV1yI4VSynGCMNMCZV RIyMyTVCtttttttttttttttttt-ttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tCAPl

CCCAtDCo VcRMcV NTYTCmCaVéVMV YTcYMcYCLRcnSIRIy7Ytttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttttttCDAl

CCCCCCAtDtAl°YTCSYncN1SRTyYTCN RSYTCtttttttttttttttttt-ttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttCDAl

CCCCCCCCCCCCCAtDtA-tÔlà RMTLN GRIyNMCGRSyéMYCtttttttttttttttttt-tttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-C0Al

CCCCCCCCCCCCCAtDtA-telo yTYCYMCc4R éYCI4V R1YnIyinYCtttttttttttttttttt-ttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttC-0DC

IIH

ΕTM JinUMl eJ-l GLnn-J CTcOHCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttC0Ôl

0C

CCCCCDtÔ

à RMTLN GRIyNMCGRSyéMYCtttttttttttttttttt-tttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttClz

CCCCDte o yTYCYMCc4R éYCI4V R1YnIyinYCYICTny7yCtttttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttttCÔ2

CCCCDt9 °RCLy3 NTYCTNnTWGninYnTYCHCnMCayRéMNTIycCayLLY YMIyYSCanC°o(Ctttttttttttttttttt-tttttttttttttttttt-tCÔl

CCCCCCCDt9tD "IyN1RI4NéVMyYCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttttttttttCÔÔ

CCCCCCCDt9t0 8T1YcITCcSyMyinYTCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttttttCÔe

CCCCCCCDt9tl o yTYCYMCc4R éYCI4V R1YnIyinYCtttttttttttttttttt-ttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttCÔ9C

Ε#Ctttttttttttttttttt-tCÔzC

CCCC0tA

°RCSYncN1SRTyYC7Y ninYnTYC1 NSyLV RIy7YCtttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttCÔP

CCCCCCC0tAtA pyTIN yinYCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttCÔP

CCCCCCC0tAtD "IyNSNéyYTCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttCÔP

CCCCCCC0tAt0 8T1YcICcSyMyinYCtttttttttttttttttt-ttttttttttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttttttttttCe2

CCCCCCC0tAtl 8T1YcITCC4yTINSNéyinYTCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttCeD

CCCCCCC0tAtÔ o yTYCYMCc4R éYCI4V R1YnIyinYCtttttttttttttttttt-ttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttCe9

CCCC0tDC°YTC1 VcRMcV NTYTCmCaVéVMV YTcYMcYC5CN3SyéRINy YC)tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-Cez

CCCCCCC0tDtA °YTCV sI4 N1SRTyYTCaYCqnYs RICtttttttttttttttttt-ttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttCez

CCCCCCCCCC0tDtAtA bVLyMyIyNMCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttttttttCez

CCCCCCCCCC0tDtAtD "1yaVGyNSNéyYCtttttttttttttttttt-tttttttttttttttttt-ttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttttCez

CCCCCCCCCC0tDtAt0 8T1YcICcSyMyinYCtttttttttttttttttt-ttttttttttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttttCeP

CCCCCCCCCC0tDtAtl "IyNSNéyYTCYIC1RI4NéVMyYCtttttttttttttttttt-tttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttC9A

CCCCCCCCCC0tDtAtÔ 8T1YcITC4yTINSNéyinYTCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttC-9D

CCCCCCCCCC0tDtAte o yTYCYMCc4R éYCI4V R1YnIyinYCtttttttttttttttttt-ttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttC90

$l

Ctttttttttttttttttt-tttttttttC9l

CCCCltA bV1yTIRéYCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttttttC9Ô

CCCCCCCltAtA bVLyMyIyNMCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttC9Ô

CCCCCCCltAtD 8MRGMjTYCCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttC9Ô

CCCCltD °FYvRGYMCcSyMyinY--------------------------ttt9e lC

CCCCCCCCltDtA

CCCCCCCltDtD °FYvRGYMCYMaNW3nccRSCtttttttttttttttttt-tttttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttCzl

urCC

CttttttCzz

CCCCÔtA byRéMNTIycCaYTCSVTyNMTC1 VcRMcV YnTYTCttttttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttCzP

CCCCCCCCÔtAtD

CCCCCCCCCCCCCCÔtAtD-tA bVLyMyIyNMCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttttttttCzP

CCCCCCCCCCCCCCÔtAtD-tD EMaycRIyNMTCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttttttCP2

CCCCCCCCCCCCCCÔtAtD-t0 ONMI YWyMaycRIyNMTCtttttttttttttttttt-tttttttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttCP2

CCCCCCCCCCCCCCÔtAtD-tl °RCLyc4YCaYC YMTYyéMYGYMITCtttttttttttttttttt-tttttttttttttttttttttttt-tttttttttttttttttt-ttttttttttttttttCPA

CCCCCCCCCCCCCCÔtAtD-tÔ O4NyvCaYCSRCxNMYCmC1 VSY7Y Ctttttttttttttttttt-ttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttC-PA

CCCCCCCCCCCCCCÔtAtD-te o VSj7YGYMICtttttttttttttttttt-tttttttttttttttttt-ttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttCPD

CCCCCCCCCCCCCCÔtAtD-t9 d yYMIRIyNMCanCL RéGYMICtttttttttttttttttt-ttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-CPD

CCCCCCCCCCCCCCÔtAtD-tz hyvRIyNMCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttC-P0

CCCCCCCCCCCCCCÔtAtD-tP èNaYCN1V RINy YCtttttttttttttttttt-ttttttttttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttCPl

CCCCCCCCCCCCCCÔtAtD-tA2 " Yn TCL VinYMIYTCSN TCaYCSRC VRSyTRIyNMCaFnMYC3yN1TyYCtttttttttttttttttt-tttttttttttttttCPe

CCCCCCCCÔtAt0 OSRTTyLycRIyNMCaYTCSVTyNMTC1 VcRMcV YnTYTC VTnSIRMICaYCSFYvRGYMC4yTINSNéyinYCtttttttCPe

CCCCCÔtD èNsYMTCaFRyaYCRnCayRéMNTIycCaYTCSVTyNMTC1 VcRMcV YnTYTCtttttttttttttttttt-tttttttttttttttttt-tttttttCA22

CCCCCCCCÔtDtA °RCcsINSNéyYCYvLNSyRIy7YCtttttttttttttttttt-tttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttCA22

CCCCCCCCCCCCCCÔtDtA-tA °RCcsIN3 NTTYC_N RSCcavrCCtttttttttttttttttt-ttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttC-A2D

CCCCCCCCÔtDtD °YCIYTICRnC3SYnCaYCINSnyayMYCtttttttttttttttttt-tttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttCA20

CCCCCCCCÔtDt0 °RCIYc4MyinYCc4VGySnGyMYTcYMIYCCtttttttttttttttttt-ttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-CA2Ô

CCCetA :n 7YySSRMcYCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttCA2P

CCCetD "vV jTYCc4y n éycRSYCYIC YcNMTI ncIyNMCtttttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttCA2P

CCCCCCCetDtA o yMcy1YTCaFYvV jTYCcR cyMNSNéyinYCtttttttttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttCA2P

ÔC

CCCCCCCCetDtD

O4y n éyYCaYCSRCSRMénYCtttttttttttttttttt-tttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttttCAA2

CCCCCCCCCCCCCetDtD-tA 8nCMy7YRnCaYCSRCLRcYCaN TRSYCaYCSRCSRMénYCttttttttttttttttttttttttttt-tttttttttttttttttt-ttttttttCAA2

CCCCCCCCCCCCCetDtD-tD 8CMy7YRnCaYTC3N aTCSRIV RnvCaYCSRCSRMénYCtttttttttttttttttttttttttttt-tttttttttttttttttt-ttttttttCAAA

CCCCCCCCCCCCCetDtD-t0 8nCMy7YRnCaYCSRCLRcYC7YMI RSYCaYCSRMénYCttttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttCAAD

CCCCCCCetDt0 O4y n éyYCaYTC1R NyTCaYCSRCcR7yIVC3nccRSYCttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-CAA0

CCCCCCCCCCCCCetDt0t-A 8nCMy7YRnCanC1RSRyTCan Ctttttttttttttttttt-ttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-CAA0

CCCCCCCCCCCCCetDt0t-D 8nCMy7YRnCanCI yéNMYC VI NWGNSRy YCtttttttttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttCAAl

CCCCCCCCCCCCCetDt0t-0 8nCMy7YRnCanC Y3N aCRS7VNSRy YCtttttttttttttttttt-tttttttttttttttttttt-tttttttttttttttttt-tttttttttttttCAAÔ

CCCCCCCCCCCCCetDt0t-l 8nCMy7YRnCanC1SRMc4Y CaYC3Nnc4YCtttttttttttttttttt-ttttttttttttttttttt-tttttttttttttttttt-ttttttttttCAAe

CCCCCCetDtl :nyIYTC1NTIWN1V RINy YTtttttttttttttttttt-tttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttCAA9

CCCet0 "vV jTYCRnCSRTY COdDCtttttttttttttttttt-tttttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttttttttttCAAz

CCCCCCet0tA bVLyMyIyNMCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tCAAz

CCCCCCet0tD .R11YSTC14sTyinYTCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttCAAz

CCCCCC

ΕȁΒȁΒ èNaYCaFnIySyTRIyNMCanCSRTY COdΪCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttCAD2

CCCetlC°RCI4V R1yYC14NINasMRGyinYC_obàrCttttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttCAD0

CCCCCCCetltA bVLyMyIyNMCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-CAD0

CCCCCCCetltD o yMcy1YCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttCAD0

CCCCCCCCCCCCCetltDt-A °YTC14NINTYMTy3ySyTRMITCtttttttttttttttttt-ttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tCADÔ

CCCCCCCCCCCCCetltDt-D °YTCTNn cYTCSnGyMYnTYTCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttCADe

CCCCCCCCCCCCCetltDt-0 °YTCR11SycRIYn TCtttttttttttttttttt-tttttttttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttCAD9

CCCCCCCetlt0 EMaycRIyNMTCtttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttCAD9

CCCCCCCetltl ONMI YWyMaycRIyNMTCtttttttttttttttttt-tttttttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttttttttttCAD9

CCCCCCCetltÔ èNaRSyIVTCaFRaGyMyTI RIyNMCanChNTcRMJCttttttttttttttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttCADz

CCCCCCCetlte :n 7YySSRMcYC1NTIWI4V R1YnIyinYCtttttttttttttttttt-ttttttttttttttttttt-tttttttttttttttttt-tttttttttttttttttt-ttttCADz

(y3SyNé R14yY------------------------------tttA0AC C eC CC C C C C C C C C C

I)AD*E+,AI*)

9C

CC°YTC cRMcY TC aYC SRC cR7yIVC 3nccRSYC Y1 VTYMIYMIfC aYC 1R C SYn C L VinYMcYC _A2gC aYTC cRMcY TC

cNMcY MYMICSYTC7NyYTCRV NWayéYTIy7YTCTn1V yYn YTrCYICSYn CIRnvCaYCGN IRSyIVC_aYCSFN a YCaYC92gC mCÔCRMTrfCnMCYMBYnCaYCTRMIVC1n3SyinYfCcNMcY MRMICSFYMTYG3SYCaYTC1 NLYTTyNMMYSTCaYCTRMIVCYIC1SnTC

1R IycnSyj YGYMICSYTCT1VcyRSyTIYTCaYCSRCT14j YCN NWLRcyRSYTCaNMICLNMIC1R IyYCSYTCNaNMINSNéyTIYTC

_àR RéRMNC YIC RSfC D22zrtC QMC aYTC LRcIYn TC inyC Yv1SyinYC cYC GRn7RyTC 1 NMNTIycC YTIC SYC YIR aC

R11N IVCRnCayRéMNTIyctC:RGTNMC_APPPrC1 VcyTYCmCcYCTnBYICHC5COYC YIR aCMFYTIC1RTCRccY1IR3SYCcR C

ySCGNayLyYCaYCLR,NMCcRIRTI N14yinYCSYC1 NMNTIycfCINnICYMCN3SyéYRMICmCnMCI RyIYGYMIC1SnTCRé YTTyLC

YIC1SnTCGnIySRMItC)tC

C8nTTyfCaYCGYySSYn TC VTnSIRITCMYCTY NMICN3IYMnTCaRMTCSRCSnIIYCcNMI YCcYTCcRMcY TCinYfC1R CSYC

aV1yTIRéYfC SYC ayRéMNTIycC YIC SYC I RyIYGYMIC 1 VcNcYC aYTC SVTyNMTC mC yTinYfC aYTC SVTyNMTC

1 VcRMcV YnTYTCYICaYTCcRMcY TCaV3nIRMITtCèRyTC1Nn CinYCSYCaV1yTIRéYCTNyICYLLycRcYfCSYC1 RIycyYMC

aNyICTR7Ny CcYCinFySC Yc4Y c4YfCcYCinyCMVcYTTyIYCSRCGyTYCmCBNn C VénSyj YCaYCTYTCcNMMRyTTRMcYTtC OY1YMaRMIfC3yYMCcNMMRîI YCSRCTVGyNSNéyYCaYTCGRSRayYTCaYTCGninYnTYTC3nccRSYTCMYC YSj7YC1RTC nMyinYGYMICaYCSRC YT1NMTR3ySyIVC1 NLYTTyNMMYSSYCanC1 RIycyYMtCOFYTICRnTTyCTNMCVI4yinYCaYCTR7Ny C

YcNMMRîI YfC1R CYvYG1SYfCSYTCTyéMYTCcSyMyinYTCaFRSY IYCYICaYC1N IY CnMCayRéMNTIycCinyC Y1 VTYMIYC

1Nn C SYC 1RIyYMIC nMYC c4RMcYC aFVc4R11Y C RnC aV7YSN11YGYMIC aFnMYC SVTyNMC 1NIYMIyYSSYGYMIC

GRSyéMYtC°FYvRGYMCcSyMyinYC yéNn YnvCaYTCGninYnTYTC3nccRSYTfCinyCaY7 RyIC-I YCTsTIVGRIyinYC

SN TC aYC INnIYC cNMTnSIRIyNMC 3nccNWaYMIRy YfC YTIYC aNMcC SFVIR1YC yMayT1YMTR3SYC YIC 1 yGN ayRSYC

1Y GYIIRMICSYCaV1yTIRéYCaYTCSVTyNMTC1 VcRMcV YnTYTtC

°FN3BYcIyLCaYCcYCI R7RySCYTICaFR3N aY CSRCaVGR c4YCcSyMyinYfCVIR1YC1R CVIR1YfCaYCSFRMRGMjTYC BnTinFRnCayRéMNTIycfCinFySCYTIC YcNGGRMaVCmCSFNaNMINSNéyTIYCaYCTny7 YCGVI4NayinYGYMItCoNn C cYSRfCSYTCSVTyNMTC1 VcRMcV YnTYTCSYTC1SnTCL VinYMIYTCTY NMICaVc yIYTCRnC1 VRSR3SYCRLyMCinYCSYC

1 RIycyYMCTRc4YCinYSCIs1YCaYCSVTyNMCYTICmC yTinYCYICinYSSYTCTNMICSYTCLN GYTCcSyMyinYTCinyCaNy7YMIC

SFRSY IY tC"MLyMfCCSYTCGNsYMTCaYC1 yTYCYMCc4R éYCI4V R1YnIyinYCaYTCSVTyNMTC1 VcRMcV YnTYTCmCSRC ayT1NTyIyNMCaYCSFNaNMINSNéyTIYCYICSYn TCyMaycRIyNMTC YT1YcIy7YTCTY NMICI RyIVTtC C C C C zC CC C C C C C C C C C C C C C C

IH ERP,DIcAI*) ERP

TRPI*)P

cDR,N),RDR+PRP PC

CCCCCCCCCCCCCCCCCCC-CCCCCCCCCC

-.- /alas-Jiuao 0 C CCCCCCCCCCCCCCCCCC-CCCCCCCCCCCCCCCCCC-CCCCCCAtAtACCONMcY1ICaYCSVTyNMCNnCaFRLLYcIyNMC1 VcRMcV YnTYC C

°YTCaY Myj YTC YcNGGRMaRIyNMTCanCé Nn1YCaFYv1Y ITCaYCSFd éRMyTRIyNMCèNMayRSYCaYCSRC:RMIVC

_dè:rC Tn C SYTC SVTyNMTC 1 VcRMcV YnTYTC aRIYMIC aYC D229C _%R MRZnSRTn ysRC YIC RSfC D229C/C %R MRZnSRTn ysRCYICRSfCD22zrtC"SSYTCNMICRMRSsTVCINnTCSYTCTsTIjGYTCYvyTIRMITCYICIYMnCcNG1IYCaYTC aY Myj YTCcNMMRyTTRMcYTCaYCSRC3yNSNéyYCanCcRMcY CaYCSRCGninYnTYCN RSYtC"SSYTCTYCTNMICRIIRc4VYTC

mC cSR yLyY C SRC MNGYMcSRIn YfC aVLyMyIyNMTC YIC cSRTTyLycRIyNMTC 1Nn C nMC ayRéMNTIycC RyTVC aRMTC SRC

1 RIyinYCcSyMyinYfCc...YTIWmWay YCmCSRC1N IVYCaYCINnIC1 RIycyYMtC

°YCcNMcY1ICinyCRnIN yTYCmCaVTyéMY CcY IRyMYTCSVTyNMTCNnCRLLYcIyNMTCcNGGYCVIRMIC1 VcRMcV YnTYTC

Y1NTYCTn CSYTCcNMTIRITCTny7RMITCHC

W °YTCVInaYTCSNMéyInayMRSYTCaYCTny7yCNMICGNMI VCinYCaYTCRSIV RIyNMTCIyTTnSRy YTCYICaYTC SVTyNMTCcSyMyinYGYMICyaYMIyLyVYTCcNGGYC5C1 VcRMcV YnTYTC)CNMIC3yYMCaNMMVCSyYnCmCnMYC

I RMTLN GRIyNMCGRSyéMYC/C

W OY IRyMYTCaYCcYTCRSIV RIyNMTfCcN YT1NMaRMICYMC1R IycnSyY CmCaYTCSVTyNMTCV sI4VGRIYnTYTC NnC3SRMc4YTfCTNMICN3TY 7VYTCRnC7NyTyMRéYCaYTCcR cyMNGYTCV1yaY GNyaYTC/C W OY IRyMYTCGNayLycRIyNMTCGN 14NSNéyinYTCYICcsINSNéyinYTCTNMICcNGGnMYTCRnCcR cyMNGYC V1yaY GNyaYCYICmCcYTCSVTyNMTfCTRMTCinFySCsCRyICL RMc4yTTYGYMICaYCSRCGYG3 RMYC3RTRSYC/C W OY IRyMYTCaYTCRSIV RIyNMTCc4 NGNTNGyinYTfC éVMNGyinYTCYICGNSVcnSRy YTC YMcNMI VYTC aRMTCSYTCcRMcY TCaYCSRCGninYnTYC3nccRSYCTNMICVéRSYGYMICaVIYcIVYTCaRMTCcYTCSVTyNMTC

1 VTnGVYTC5C1 VcRMcV YnTYTC)CNnC5C1 VGRSyéMYTC)tC

°YTCIY GYTC5C1 VcRMcV YnvC)fC5C1 Vcn TYn C)fC5C1 VGRSyMC)fC5CMVN1SRTyYCyMI RWV1yI4VSyRSYC)CYIC

5C1NIYMIyYSSYGYMICGRSyMC)CTNMICnIySyTVTCaRMTCSRCSyIIV RIn YC1Nn CaVc y YCaYTCRT1YcITCcSyMyinYTC

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