Les avulsions dentaires au cours du traitement orthodontique à Conakry / NA

En orthodontie, l'extraction des dents saines tient une place importante parmi les moyens thérapeutiques, pour le rétablissement d'une denture fonctionnelle et esthétique. Objectifs : les objectifs étaient de déterminer la fréquence des avulsions au cours du traitement orthodontique, répertorier les types d'anomalies orthodontiques qui nécessitent des extractions dentaires et identifier les dents les plus couramment extraites. Méthodes. il s'agit d'une étude prospective de type descriptif, effectuée au service d'odontostomatologie et de chirurgie maxillofaciale de l'hôpital national Donka, CHU de Conakry sur la période d'août 2019 à avril 2020. Résultats : trois cent patients ont été examinés, 31 présentaient des anomalies orthodontiques dont les traitements nécessitaient des extractions dentaires pilotées, soit une fréquence de 10,33%. L'âge moyen était de 11 ans. Le sex-ratio était de 1,21 en faveur du sexe masculin. L'encombrement antérosupérieur était l'anomalie la plus fréquente (58,06%), les incisives temporaires étaient les dents les plus intéressées par les extractions avec 41,18%. Conclusion. La maitrise des indications, du moment et des séquences d'extractions à but orthodontique constitue l'élément clé dans la prise en charge des anomalies orthodontiques en omni pratique.

Public health challenges of restorative dental practice in low resource settings during the Covid-19 pandemic

Background: COVID-19 remains a major public health threat globally, and has challenged healthcare systems and services including oral health Objective: This study examines the key public health challenges posed by the COVID-19 pandemic in low resource settings. While healthcare services are learning to cope with the COVID-19 pandemic, dental care services, in particular restorative dental practice have been adversely impacted because of the closeness of caregivers to the patient's mouth as well as the generation of aerosols during most restorative procedures. This presents a challenge for low-and-middle-income countries (LMICs) such as Nigeria where weak and poor governance structures characterize healthcare systems in addition to paucity of economic resources. Another challenge in the form of COVID-19 conspiracy theories has threatened to undermine public health efforts designed to control the pandemic. Conclusion: The implementation of optimal guidelines and safety protocols for effective COVID -19 infection prevention and control is a major challenge for restorative dental care practice in low resource settings owing to paucity of key material resources and inappropriate behaviour associated with lingering doubts about COVID-19 reality among the majority of the populace. The Safer Aerosol-Free Emergent Dentistry concept offers a viable practical approach for restorative dental practice in LMICs during and in the post COVID-19 pandemic era. There is a need to deploy all resources, human and material, in the education and enlightenment of the populace regarding the reality of COVID-19.

Evaluation of patients' compliance to recall visits after tooth extraction at the Dental Centre, University of Benin Teaching Hospital (UBTH): A two-year retrospective study

ABSTRACT Objective: This study aims to evaluate the level of patients' compliance with recall / follow-up visits attending the dental Centre of the University of Benin Teaching Hospital (UBTH).Methods: This study adopted a descriptive retrospective study of case notes retrieved from the medical records department of the dental Centre, University of Benin Teaching Hospital. The period under study covers 2019 to 2021. The data was collected by means of 1232 questionnaire and analyzed using descriptive statistics such as frequency and percentages. Results: The result showed that the participants in the age bracket of 18-40 years of age (277) complied better to recall visit in comparison with the study age distributions which are 41-65 years (218) and age above 65 years (188). As per the influence of gender on compliance of patients with post-extraction recall visits, it was observed that the male participants (288) responded better to the recall visits compared to the female participants (251). The Relationship between distance away from the hospital and compliance of patients with post-extraction recall visits was also evaluated, and it was observed that the patients closer to the hospital within 5km (442) complied better to recall revisit in comparison to the participants who were within 10km (224) from the hospital as well as the participants that were 10km & above (17). Finally, the influence of interval between procedure and recall visit was also evaluated, and the result revealed that the participants that were given 7 days of recall revisit (663) complied better compared with the participants who were given 14days duration for recall revisit (478). Conclusion: The data from this study highlighted the possible need for a paradigm shift in patient-doctor interphase especially as it concerns recall visits. Compliance to recall appointment by the patients depends largely on age, gender, distance from hospital and interval between procedures and is mainly responsible for the noncompliance of patients to recall visit

Oral Health Care Habits and its Role in Preventing Adverse Prenancy Outucomes in Rwanda

More than 20 million infants in the world (15.5 of all births) are born preterm with low birth weight (PLBW). Ninety-five of them are in developing countries and the rate of PLBW in developing countries is more than double (16.5) that in developed countries. It has been suggested that oral infection can act as the site of origin for dissemination of periodontopathogens and their toxins as well as induce inflammatory mechanisms to distant body sites; thus linking periodontal diseases to pre-term delivery of low birth weight (PLBW) infants. The objective of this study was to assess the general oral health care habit of pregnant mothers in order to determine its association with premature delivering of low birth weight infants.Methods: Study participants were asked to complete a questionnaire to obtain information regarding their oral health care habits and the responses linked to their gestation term and time of delivery. In addition; their mouths were examined for gingival inflammation and / or bleeding which might be attributed to lack of oral health care. Results and conclusion: Although in this study oral health care habits of the mothers did not appear to directly influence the gestation period and birth weight of the infants; the resulting gingival inflammation and bleeding showed a significant correlation with PLBW (p = 0.004). Therefore maternal dental care during pregnancy and good oral hygiene habits could be highly recommended. Also more detailed examination and assessment of the oral health status of mothers with particular emphasis on periodontal disease and its association with adverse pregnancy outcomes are needed

Prevalence et facteurs de risque de transmission des hepatites virales B et C chez les couples maries en 2008 dans la Wilaya d'Alger

L'Algerie est classee comme pays de moyenne endemicite avec un taux de prevalence de l'hepatite B qui varie entre 2-8. Notre etude a pour objectif d' identifier la prevalence de l'hepatite B et la prevalence de l'hepatite C ainsi que les facteurs de risque de transmission chez les couples qui ont decide de se marier dans la wilaya d'Alger durant l'annee 2008. Parmi les virus des hepatites; on a choisi de nous interesser uniquement aux hepatites virales B et C; qui ont en commun les memes facteurs de risque de transmission et la propension a entrainer des infections persistantes; responsables d'hepatites chroniques evoluant vers la cirrhose et le cancer primitif du foie. Materiels et methodes : Il s'agit d'une etude descriptive; transversale de type prospectif; qui a porte sur un echantillon de 2984 personnes qui ont l'intention de se marier dans la wilaya d'Alger durant l'annee 2008. Sur la base de deux elements; le nombre de mariages par commune et par mois; un echantillon representatif a ete etabli par allocation proportionnelle. Resultats : Un prelevement avec recherche systematique d'une seropositivite aux hepatites B et C a permis de depister 16 personnes. La proportion des couples presentant une seropositivite aux virus des deux hepatites est de 0.5. La prevalence de l'hepatite B depistee est de 0;2et la prevalence de l'hepatite C de 0;3. Parmi l'ensemble des facteurs de risque recherches; les soins dentaires representent 88.5; le piercing 50.8et la hijama 19.5. Discussion : Notre etude a concerne une population jeune censee etre en bonne sante et chez laquelle on ne devrait pas trouver; a priori; une serologie positive au VHB ou au VHC; ce qui explique les chiffres peu eleves de prevalence de l'hepatite B (0;2) et de l'hepatite C (0;3). Ces donnees ne concernent que la wilaya d'Alger soit le dixieme de la population algerienne et pour un groupe de population bien determinee. Il n'est pas permis d'extrapoler ces resultats au reste de la population. Des etudes similaires doivent etre entreprises dans les autres regions du pays ou semblent dominer des comportements a risque de transmission du VHB et du VHC. Conclusion : L'opportunite instituee par la legislation actuelle devrait etre saisie juste avant la nuptialite. La consultation prenuptiale doit etre institutionnalisee; Le depistage de l'infection par le virus de l'hepatite B et de l'infection par le virus de l'hepatite C ainsi que celui des IST doivent imperativement faire partie du bilan prenuptial. Les textes actuels doivent etre amendes et completes. La vaccination contre l'hepatite B doit etre fortement recommandee avant le mariage

Dental Care Utilization and Satisfaction of Residential University Students

Aim: The objective of this study was to provide information on the level of utilization and satisfaction of residential university students with the dental services provided by the dental clinic of a teaching hospital. Volunteers and Material: A stratified sampling technique was used to recruit volunteers from the outpatient clinic of the Obafemi Awolowo University Teaching Hospital Complex; Ile-Ife; Nigeria. Information was collected by a self-administered questionnaire composed of questions that measure the level of utilization and satisfaction with the dental services provided. Questionnaires were provided to 650 randomly chosen students residing in the University hostels. There were 39 refusals; and 6 incomplete questionnaires were discarded. This left a sample size of 605 volunteers. Results: Forty seven students (7.8) indicated that they visited the dental hospital within the last 12 months. Males and females utilized the dental services equally; and utilization increased with age and the number of years spent on campus. Anticipation of painful dental treatment; high dental charges; long waiting times and being too busy for a dental visit were cited as the most important impediments to seeking dental treatment. Females expressed greater satisfaction with the services. Conclusion: Dental service utilization among the students was found to be low. Oral health awareness campaigns; improving the quality of the services; and shortening the waiting time are expected to increase service utilization and satisfaction

Evaluation of correlations between socio-demographics and oral health seeking among patients

Background: It is commonly reported that individuals at higher socioeconomic class have greater health awareness culminating in better care-seeking from orthodox facilities. It is yet to be ascertained whether this reflect in attitudes of patients toward seeking oral health care. Aim: This study was designed to evaluate the effect of certain socio-demographic indices on oral health care-seeking in an urban society where adequate facilities are available. Methods: A one point observational study of the patients attending the Dental Clinic of the University College Hospital; Ibadan; was conducted using a questionnaire which sought to document the levels of education; income; marital status and the oral health seeking practice of the patients. The appropriate treatments for individual patients were also documented. Results: One hundred and three patients participated in the study that spanned three months (1st April- 30th June; 2006). Fifty-six (54.4) of the patients were males while 47(45.6) were females with age range of 19-85 years and average of 39 years. Eighty-six (83.4) patients had at least secondary school education of which 65 (63.1) actually had tertiary education. There was no significant correlation between oral health seeking behaviour and level of education; level of income; and marital status. Seventy -four (71.8) of the patients had tooth extractions while the remaining patients had non-surgical treatments. The reasons for preponderance of surgical treatment needs were discussed. Conclusion: Although a larger proportion of the dental patients were well educated and had better income; this did not reflect in their oral health seeking behaviour

Les soins dentaires chez la femme enceinte

La grossesse est un état physiologique caracterisé par des modifications hormonales ayant des repercussions bucco-dentaires. La plupart des praticiens appréhendent le déroulement des soins dentaires au cours de ces neuf mois. Il nous parait utile de mettre le point sur les particularités physiologiques durant chacun des trois trimestres de gestation d'une part; et les possibilités et les limites thérapeutiques d'autre part; afin d'éliminer toute ambiguité sur la prise en charge de la femme enceinte

Traitement des caries par quadrant chez l'enfant

Les traitements par quadrant permettent une rapidité et une efficacité des soins dentaires chez l'enfant, lorsque celui ci est coopérant. La réussite de l'anesthésie et l'isolement parfait des dents par un champ opératoire constituent les deux éléments clés du succès des traitements par secteur.Ces deux étapes préalables aux soins seront décrites dans cet article et les différents traitements ainsi que les matériaux utilisés seront présentés à travers un cas clinique suivi au service d'odontologie pédiatrique du centre de consultation et de traitement dentaire de Casablanca

Diabète et état parodontal (2ème partie)

Le traitement de la maladie parodontale chez le diabétique nécessite l'évaluation de certains facteurs systémiques en rapport avec le diabète et ses complications. Cet articles expose le rôle du chirurgien dentiste dans le maintien de la stabilité du diabète par l'instauration d'une thérapeutique parodontale appropriée, ainsi que la conduite à tenir adéquate lors de la prise en charge du patient diabétique

Prophylaxie de l'endocardite infectieuse en chirurgie dentaire

Chez les sujets porteurs de cardiopathies; une antibioprophylaxie bien adaptee et appliquee lors des situations ou gestes invasifs dentaires devrait diminuer le taux des greffes osleriennes qui sont grevees d'une morbi- mortalite importante. La sphere bucco-dentaire reste le site le plus pourvoyeur de bacteriemies. La prescription de l'antibioprophylaxie depend de la cardiopathie sous-jacente et du type de geste bucco-dentaire a realiser. Son efficacite a ete clairement prouvee par de nombreux auteurs qui ont demontre une reduction extremement variable mais significative du risque d'endocardite infectieuse. Le succes de cette prevention est etroitement lie a la diffusion et a l'application des recommandations sur l'antibioprophylaxie et a une meilleure collaboration Medecins- Chirurgiens dentistes

La sedation consciente par inhalation du melange equimolaire oxygene-protoxyde d'azote (meopa) : une methode actuellement utilisee pour traiter les enfants difficiles au centre de consultations et de traitements dentaires de Casablanca

A l'heure actuelle pour faire face aux difficultes de cooperation lors des soins dentaires; la sedation par inhalation de MEOPA est l'une des methodes de sedation consciente les plus utilisees. Cette pratique s'est developpee depuis tres longtemps dans la plupart des pays industrialises; alors qu'au Maroc; elle est restee absente de l'arsenal therapeutique. Sa mise en place au centre de consultations et de traitements dentaires (CCTD) de Casablanca pour la prise en charge de la douleur et de l'anxiete chez l'enfant; permet aujourd'hui l'acces aux soins dentaires a un bon nombre de patients initialement opposants. L'objectif de ce travail est de faire le point sur l'interet et les principes d'utilisation du MEOPA en odontologie et de decrire comment sont organises les soins dentaires sous sedation par inhalation au CCTD de Casablanca. Des cas cliniques d'enfants traites sous cette modalite de prise en charge sont egalement presentes

La Thrombasthenie de Glanzmann : principes et precautions de la prise en charge odontostomatologique

La maladie de Glanzmann (ou thrombasthenie de Glanzmann) est la thrombopathie congenitale la mieux connue. Dans cette affection; la transmission suit un mode autosomique recessif. Elle est due a des anomalies quantitatives et/ou qualitatives de l'integrine alphaIIb beta3. Ce recepteur d'adherence des cellules est essentiel pour l'agregation plaquettaire et permet la formation d'un clou hemostatique en cas d'alteration des vaisseaux lors d'une blessure. Le diagnostic repose sur les saignements muco-cutanes avec l'absence d'agregation plaquettaire en reponse aux stimuli physiologiques; associes a une numeration et une morphologie plaquettaire normales.La maladie de Glanzmann est une pathologie rare; souvent rencontree dans un contexte de consanguinite. Le tableau clinique de la thrombasthenie de Glanzmann est variable : certains patients presentent seulement quelques ecchymoses alors que d'autres ont des hemorragies frequentes; severes et parfois fatales. Les manifestations bucco-dentaires de cette maladie sont : petechies; ecchymoses et gingivorragies. Bien qu'elle soit une maladie hemorragique severe; la thrombasthenie de Glanzmann; lorsqu'elle est bien prise en charge; est associee a un pronostic tres favorable.L'observation rapportee va illustrer la prise en charge bucco-dentaire d'un enfant presentant cette maladie

Dental and related problems in chidlren: causes and management

"This article provides a summary of the common dental problems as seen in clinical practice in Uganda. These may be divided into two broad categories. A. CONGENITAL. B. ACQUIRED. A. CONGENITAL - These are conditions that develop before birth; during foetal development. Generally speaking; these are commonly first noticed by the mother and are presented to the dentist as her concern usually in the first year of life of the child. They include conditions such as:- - neonatak teeth - Neonatal gingival cysts - Cleft lips et Palatal - Discoloration - Tongue-tie. NEONATAL TEETH - These are similar in appearance to real teath. They come with the baby from the womb. They are generally a source of great concern and worry to the parents since they are associated with certain cultural beliefs. These teeth are alsmost always loose; thus presenting a possibility of being disloged into the airway. Management consists of simple excision/extraction. NEO-NATAL GINGIVAL CYSTS - These are fluid containing; sac like swellings; commonly located on the tooth bearing part of the gums. there is a generally held belief; albeit mistakenly; that once the sac bursts and the fluid is swallowed by the baby; it will die. Management consits of: 1) Education 2) Reassurance 3) Incision through the cyst. CLEFT LIPS et CLEFT PALATE - This is a congenital abnormal space or gap in the upper lip or/and palate colloquially known as ""harelip"". these defects constitute a serious afflication to those who ahve them; especially as adults. Because of the grotesque appearance; cleft lips and cleft palates are a source of considerable shock to the parents of the applicted baby. These clefts are usually accompanied by missing teeth; malpositioned teeth; speech difficulties; and poor feeding capability. Management is complex and protracted. It requires the concerted effort of the parents; oral surgeon; and orthodontist. it involves: - Surgical reconstruction. The timing of the corrective surgery still remains a debatable issue. Most surgeons adhere to the so called 'rule of 10' which is; '10 weeks of age; 10 pounds of body weight and atleast 10 gm of haemoglobin'. - Orthodontic correction of malpositioned teeth is aimed at repositioning teeth to restore normal appearances and occlusion. - Artificial replacement of missing teeth. - Speech therapist. - Explanation and reassurance to the parents."