Profiles of sugar fermenting bacteria of the oral cavity among children with dental caries attending stomatology services at Ruhengeri referral hospital in Musanze District, Northern Rwanda

Background: Dental caries remains a public health threat of concern among children. About 2.3 billion people are affected by dental caries, of which 530 million are children globally. Objective: This study was carried out to identify sugar fermenting bacteria in the oral cavity and their antibiotic susceptibility pattern, assess the association with sugar fermenter bacteria and dental caries and evaluate dental caries outcomes among children. Materials and Methods: This was a cross-sectional study conducted between October 2021 and February 2022 at Ruhengeri Referral Hospital. About 136 oral swab samples were collected from children with and without dental caries at 1:1 ratio. The samples were put in Stuart sterile container and transported to INES-clinical microbiology laboratory for microbial identification. Logistic regression analysis of demographic characteristics was performed to study the relationship between demographic variables and dental caries. Chi-square test was performed for the association between variables. Results: About 67.6% were male, while children of age 7­9 years (64.7%) dominated the age groups. Lactobacilli spp (15.29%) and Streptococcus mutans (12.94%) were the most predominant microorganisms observed in the oral cavity among children with dental caries. The S. mutans (x2 = 27.03, P < 0.00001, 95% confidence interval [CI]=0.2901­0.5785), S. aureus (x2 = 34.59, P < 0.00001, 95% CI = 0.3541­0.6292), Enterobacter aerogenes (x2 = 13.5, P = 0.000239, 95% CI = 0.151­0.4622), Serratia marcescens (x2 = 11.64, P = 0.00645, 95% CI = 0.1275­0.4418) and Klebsiella pneumonia (x2 = 13.51, P = 0.000237, 95% CI = 0.1511­0.4623) were significantly associated with dental caries. Teeth loss (x2 = 51.04, P < 0.00001, 95% CI = 0.4757­0.7205), teeth pain (x2 = 5.05, P = 0.0246, 95% CI = 0.0249­0.33499), and infection (x2 = 4.73, P = 0.02964, 95% CI = 0.0186­0.3441) were dental outcomes associated with tooth decay. Ciprofloxacin, clindamycin, and amoxicillin were the most sensitive antibiotics, while vancomycin and chloramphenicol were the most resistant. Conclusion: Sugar consumption favours the growth of sugar fermenter bacteria that cause dental caries among children. Dental caries is associated with adverse oral health outcomes among children. Oral health education is recommended for children. Parents are advised to reduce the consumption of sugary food for their children for oral health safety.

The normal range of maximal incisal opening in pediatric population and its association with physical variables

Background: Restricted mouth opening is a common complaint in patients suffering from temporomandibular joint disorders, ankylosis, impaired masticatory muscle function, rheumatic disease, infection, or malignancy. As with any disease, the aim of treatment of disorders affecting mouth opening is to restore the mouth opening to its normal value. It is thus of paramount importance to determine the normal value. Objective: To establish the normal range of maximal incisal opening (MIO) in children aged 4 to 15 years and to investigate the correlation between MIO and age, gender, height, and body weight. Materials and Methods: Six hundred and two children from various schools in Bengaluru, India, participated in the study. The children were divided into the following age groups: 4­5, 6­7, 8­9, 10­11, 12­13, and 14­15 years. MIO for the children was recorded using Therabite® scale. The measurements of MIO were then correlated with gender, body weight, and height of the children in different age groups. Results: It was observed that MIO gradually increased with age with a mean MIO of 41.34 mm at 4­5 years to a mean MIO of 51.73 mm at 14­15 years. The mean MIO value for males (48.90 ± 6.49 mm) was found to be higher when compared to that of females (46.17 ± 5.58 mm). The results indicated a strong positive correlation of MIO with height and weight. Conclusion: MIO gradually increased with age in both the genders, and a strong positive correlation of MIO with height and weight was observed

Utilisation de la boule de Bichat dans le traitement de la communication bucco-sinusienne iatrogène: à propos d'un cas

La communication bucco-sinusienne fait partie des complications per et post opératoires rencontrées au cours de l'avulsion des dents antrales, notamment les deuxièmes prémolaires et les premières molaires maxillaires. Nous rapportons le cas d'une jeune patiente de 23 ans, chez la quelle l'avulsion laborieuse de la 16 (première molaire maxillaire droite) a conduit à une communication bucco-sinusienne, dont la thérapeutique de première intention par lambeau de translation vestibulaire de plein épaisseur a échoué. La reprise chirurgicale associant le lambeau vestibulaire à la boule de Bichat, a permis la fermeture hermétique de la communication. Notre résultat a été comparé aux données actuelles de la littérature

Oral Amelanotic Melanoma

Malignant melanomas of the mucosal regions of the head and neck are extremely rare neoplasms accounting for less than 1of all melanomas. Approximately half of all head and neck melanomas occur in the oral cavity. Less than 2of all melanomas lack pigmentation; in the oral mucosa however; up to 75of cases are amelanotic. No etiologic factors or risk factors have been recognized for oral melanomas. Some authors have suggested that oral habits and selfmedication may be of etiological significance. Oral melanoma is rare but it is relatively frequent in countries like Japan; Uganda; and India. It is rarely identified under the age of 20 years. In Australia where cutaneous melanomas are relatively common primary melanoma of the oral mucosa is rare. The surface architecture of oral melanomas ranges from macular to ulcerated and nodular. The lesion is said to be asymptomatic in the early stages but may become ulcerated and painful in advanced lesions. The diagnosis of amelanotic melanoma is more difficult than that of pigmented lesions. The neoplasm consists of spindle-shaped cells with many mitotic figures and no cytoplasmic melanin pigmentation. Immunohistochemistry using S-100; HMB-45; Melan-A and MART-1 will help in establishing the correct diagnosis. Radical surgery with ample margins and adjuvant chemotherapy are appropriate management protocol for malignant melanoma. Oral melanoma is associated with poor prognosis but its amelanotic variant has even worse prognosis because it exhibits a more aggressive biology and because of difficulty in diagnosis which leads to delayed treatment

Coping with Oral Pain: Lay Management Strategies Adopted by Patients Prior to Presentation

Objectives:To identify lay measures taken by patients in response to oral pain before seeking professional care and to determine factors leading to demand for professional oral health care.Methods: A cross-sectional survey of patients aged 16 years and above who presented with oral pain at the oral diagnosis clinics of the Lagos University Teaching Hospital and the Lagos State University Teaching Hospital was carried out. Data was collected by means of questionnaires which sought information on onset and duration of pain; character; aggravating and relieving factors and actions taken by the patients before presentation at the dental clinic. Results: A total of 215 patients participated. More than half of them described their pain as severe to very severe with 106(49.3) and 21(9.8) reporting sleep disruptions and severe agony respectively. Delay in presentation range from over a month in 56(26) patients to years in 85(39.5). Responses to pain symptoms included; communication with different persons for advice in 192(89.3) and application of at least one lay measure in 183(85.1) patients. Duration and persistence of pain was associated significantly with the use of more than one measure. There was no association between gender or age and the use of lay measures. Use of measures with possible adverse effects like petrol and acid was reported in 5(2.7) of the respondents. Conclusion: Lay strategies in response to oral pain are common in this Nigerian population and appear to be used as an alternative to professional oral health care

Evaluation et prise en charge de l'envahissement mandibulaire dans les carcinomes epidermoides de la cavite orale et de l'oropharynx

Objectif : Le but de notre etude est l'evaluation de l'atteinte mandibulaire dans les carcinomes epidermoides de la cavite orale et de l'oropharynx. Materiel et methodes : Il s'agit d'une etude retrospective a propos de 34 patients colliges sur 6 ans (1999-2004) et ayantun carcinome epidermoide de la cavite orale et/ou de l'oropharynx avec envahisse- ment mandibulaire confirme a l'anatomopathologie.L'atteinte mandibulaire a ete evaluee par l'examen clinique; l'orthopantomographie; la tomodensitometrie; et par les constata- tions peroperatoires du chirurgien. Tous les patients ont eu un evidement ganglionnaire; une exerese tumorale associee a une mandibulectomie segmentaire interruptrice ou conservatrice. Resultats : L'envahissement mandibulaire a ete suspecte cliniquement chez 70;5des patients devant l'adherence de la tumeur a l'os. Apres examen clinique et imagerie; cette atteinte a ete diagnostiquee chez 88;2des patients. Dans 11;8des cas; l'atteinte n'a ete suspectee qu'en peroperatoire. L'examen histologique a confirme l'atteinte osseuse chez tous les patients. La mandibulectomie segmentaire a ete pratiquee chez 17 patients devant l'atteinte du canal mandibulaire. Vingt-huit patients ont eu une radiotherapie postoperatoire a la dose moyenne de 64 Gy. Les taux de recidive; de metastase et de deces etaient respectivement de 11;7; 17;6et 17;6pour les patients qui ont eu une mandibulectomie segmentaire; et de 23;5; 17;6et 23;5pour ceux qui ont eu une mandibulectomie conservatrice. Par ailleurs; 76;5et 29;5 des patients ayant eu respectivement une mandibulectomie segmentaire et une mandibulectomie conservatrice avaient une gene fonctionnelle importante lors de l'alimentation.Conclusion : L'examen clinique; l'imagerie et l'examen peroperatoire sont d'un apport capital dans l'evaluation de l'atteinte mandibulaire. Une atteinte epargnant le canal mandibulaire justifie une mandibulectomie conservatrice permettant d'avoir de meilleurs resultats esthetiques et fonctionnels tout en assurant un controle carcinologiquement satisfaisant

Functional and Selective Neck Dissection (IIa) Following Squamous Cell Carcinoma of the Plate

Background: Neck dissection has been an adjunct surgical procedure in the management of malignancies affecting the head and neck region. Radical neck dissection was the original surgical procedure for the treatment of regional neck metastases. The aim of this paper is to report the management of a female patient with regional neck metastases from squamous cell carcinoma affecting the hard palate.Methods: A case report of a 60-year-old patient with squamous cell carcinoma of the palate who later manifested with an enlarged unilateral cervical lymph node ten weeks after surgery on the primary site. A functional and selective neck dissection in which the accessory nerve; internal jugular vein and sternocleidomastoid muscle were preserved and only the lymph node at the IIa level was removed was carried out under local anaesthesia.Results: The malignant ulcer on the palate was excised and the neck was dissected to remove the clinically enlarged lymph node. These procedures were uneventful and patient was referred for post- operative radiotherapy for possible residual tumours.Conclusion: There is need to reduce the morbidity and mortality associated with the radical neck dissection and this has led to the use of various levels of selective neck dissections as in the case presented

Oral manifestations of viral infections

Examination of the oral cavity is an integral part of every clinical examination. The clinical presentation of various viral conditions is discussed in this article and will provide the family practitioner with an up to date guide to better diagnosis and management

Lesions muqueuses d'origine prothetique chez l'edente total : prise en charge therapeutique : a propos d'un cas clinique

Chez de nombreux patients; le port d'anciennes protheses completes peut etre a l'origine de diverses lesions au niveau de la muqueuse buccale. Ces lesions peuvent etre hyperplasiques; de type epulis fissuratum ou cretes flottantes ou non tumorales telles que la stomatite sous prothetique. Cet article; expose a travers un cas clinique; les demarches therapeutiques des lesions de la fibro-muqueuse; secondaires au port de protheses mal adaptees et ce; en vue d'une rehabilitation prothetique conventionnelle

L'halitose d'origine intra-orale et son traitement en parodontologie

L'halitose correspond à l'odeur offensive en provenance de la cavité buccale (mauvaise haleine). Sa prévalence est variable mais reste relativement élevée, elle constitue ainsi un problème majeur et un handicap à l'intégration sociale.L'halitose est d'origine intra-orale dans 85 à 90% des cas. Les maladies parodontales et l'enduit lingual sont les principales causes orales responsables.D'un point de vue étiopathogénique, l'halitose provient des composés chimiques désodorants produits par le processus de dégradation et putréfaction bactérienne des protéines contenues dans les débris alimentaires et cellulaires, le sang et le fluide gingival.Le traitement de l'halitose est principalement étiologique. Il fait appel à une réduction mécanique des micro-organismes et de leurs substrats, par le traitement des maladies parodontales et la maitrise de l'hygiène bucco-dentaire et surtout linguale.Secondairement une approche chimique sera préconisée, elle permettra la réduction de la charge bactérienne, la diminution de l'expression des composés des gaz désodorants volatiles et leur conversion en non volatiles, ceci à l'aide d'agents antibactériens et d'agents neutralisants actifs