Assessment of dentists' knowledge in rabat concerning the management of dental expulsion.

INTRODUCTION: Dental avulsion is an emergency whose prognosis depends on the promptness of the treatment. Adequate management requires the acquisition of correct knowledge, attitude and practice, thus the prognosis of the avulsed tooth should be improved, both in the short and in the long term. AIM: This study was carried out in order to assess the level of knowledge, attitude and practice of dentists working in the city of Rabat, Morocco regarding their management of avulsed teeth and the factors associated with this level. METHODS: A 14-item questionnaire regarding dental avulsion and its management was administered to dentists working in private practice in Rabat using convenience-sampling methodology. The data obtained were entered into Statistical Package for the Social Sciences database (IBM, SPSS version 13.0, Chicago, USA) and analysed with a significance level established at p < 0.05. The knowledge, attitude and practice level was assessed using a scoring system. Chi2 and Fisher's Exact tests were used to compare the groups. RESULTS: A total of 205 dentists, representing 37% of all dentists working in the private sector in Rabat, completed the questionnaires. The level of knowledge, attitudes and practices of the dentists in this study was moderate with an overall median score of 5 [4;6]. Most of the participants answered the knowledge based questions correctly, except for those concerning the extra-alveolar period, the timing of endodontic treatment, and the type and duration of retention. CONCLUSION: Given the lack of other studies concerning Moroccan dentists, comparison with studies carried out in other countries is difficult, hence the need to carry out more Moroccan studies in order to improve this level.

CBCT Evaluation and Conservative Management of a Large Periapical Lesion Associated with Dens Invaginatus Type II.

This case report illustrated the conservative management of an invaginated type II tooth with a large periapical lesion. This dental malformation is characterized by the complexity of root canal anatomy, which when associated with a periapical lesion complicates the performance of conventional endodontic treatment, hence resulting to the difficulty of obtaining the optimal disinfection of the root canal system, which is an essential element for the success of any endodontic treatment. In the present case report, clinical and radiographic examinations were supplemented by CBCT examination to identify the root canal configuration and the extension of the periapical lesion. Conservative orthograde endodontic treatment was performed by combining mechanical and chemical action. Additionally, active nonsurgical decompression was performed and the follow-up visits revealed a favorable outcome.

Effect of Vital Bleaching on Micromorphology of Enamel Surface: an in Vitro Study.

OBJECTIVES: The aims of this in vitro study was to investigate the effects of bleaching agents commonly used in micromorphology of the enamel surface and to assess the effect of concentration and of adding fluoride in the bleaching agents. METHODS: Sixty freshly extracted intact teeth were stored in distilled water. One half of each tooth was served as control, the other part was treated with bleaching agent. Samples were randomly divided into six groups of ten, according to the bleaching agents: G1- at-home-CP10; G2- at-home-CP16; G3- at-home-CP22; G4- in-office-CP35; G5- in-office-HP40 with fluoride; G6- in-office-HP40 without fluoride. Enamel specimens for each group were then submitted to a quantitative scanning electron microscopy. Number of pores and their diameter were measured to assess porosity of enamel surface. RESULTS: SEM analysis revealed enamel surface porosity after bleaching. Significant increase in number and major diameter of pores in bleached samples (p<0.001) were observed. The comparison between samples treated with 10% PC and samples treated with 22% PC showed significant increase in number of pores (p=0.006) and major diameter (p=0.001) from samples treated with 22% PC. Statistical analyses showed significant increase in the number of pores (p=0.006) from samples treated with 40% HP without fluoride compared to samples treated with 40% HP containing fluoride. CONCLUSIONS: Bleaching products with low concentration cause less porosity at surface of the enamel compared to concentrated products. Adding fluoride in the bleaching agent appears to reduce porosity of enamel surface.

Prevalence and risk factors of Apical periodontitis in endodontically treated teeth: cross-sectional study in an Adult Moroccan subpopulation.

BACKGROUND: The present study aimed at investigating the prevalence of Apical periodontitis in a Moroccan Adult subpopulation with a non-surgical root canal treatment and to assess associated risk factors including endodontic treatment quality, periodontal health status, coronal restoration cavity design and quality. METHODS: A total of 358 endodontically treated teeth were evaluated after more than 1-year period in a Moroccan subpopulation according to predetermined criteria. Studied parameters were assessed clinically and radiographically. The association between coronal restoration quality, cavity design, periodontal status, root canal filling quality, coronal restoration related features, presence or absence of the opposing dentition and the periapical status was determined. Data were analyzed using chi-square test, odds ratio and logistic regression. RESULTS: The present study revealed that gingival health, coronal restoration with CL II cavity design, and root canal filling quality influenced periapical status of endodontically treated teeth. Multivariate analysis showed that this association was statistically significant for gingival inflammation (95% CI 1.08-3.91, OR 2.05, p = 0.02), inadequate coronal restoration (95% CI 1.16-4.04, OR 2.16, p = 0.01), inadequate root canal filling length and homogeneity (95% CI 1.24-3.01, OR 1.93, P = 0.004), (95% CI 1.41-4.44, OR 2.50, p = 0.002) respectively. CONCLUSIONS: The present study revealed that inadequate coronal restorations especially with large proximal margins (CL II cavity design) and gingival inflammation increased the risk of apical periodontitis in endodontically treated teeth. Prevalence of Apical periodontitis in the present study was 72.1%.

[Role of enamel microabrasion associated with external bleaching in the management of patients with dental fluorosis]. / La micro-abrasion amélaire associée à l'éclaircissement externe: intérêt dans la prise en charge de la fluorose.

Dental fluorosis is a developmental anomaly affecting aesthetic appearance. The association between microabrasion and external bleaching has shown satisfactory outcomes because it improves aesthetic outcome in patients with light dental fluorosis. The purpose of this study was to update the role of this association as well as its different effects on the enamelled surface.

Knowledge, attitudes and self-reported practices toward children oral health among mother's attending maternal and child's units, Salé, Morocco.

BACKGROUND: The occurrence of severe dental caries is particularly prevalent and harmful in children. A better understanding of parental factors that may be indicators of children's risk of developing dental caries is important for the development of preventive measures. This study was conducted to assess knowledge, attitudes, and practices (KAP) of mothers in Salé, Morocco regarding oral health and their predictors. METHODS: A cross-sectional KAP study was conducted of Mother and Child units in Salé, Morocco. Mothers attending the selected units from November 2014 to 29 January 2015 were recruited. Data were collected using a semi-structured questionnaire, administered by face-to-face interviews, to record socio-demographic factors and KAPs. The main outcome measures included knowledge about oral health diseases and preventive measures, and attitudes and practices related to oral health prevention measures and dental care. KAPs scores were then recoded based on responses and scores were determined for each KAP domain. Linear regression analysis was conducted to assess predictors of KAP scores. RESULTS: Among 502 mothers included, 140 (27.8%) were illiterate and 285 (60.9%) were aware that fluoride has a beneficial effect in caries prevention. Mothers' own practices about dental care were statistically related to their children's use of dental care services (p < 0.001). Multiple linear regression analysis revealed that the knowledge score was associated with mother's age (ß = 0.05; 95% CI; p < 0.001), education level, and median income (ß = 0.38; p = 0.04). Significant predictors of oral health-related practices were mother's education level and children's health status. CONCLUSIONS: Limited KAP scores were observed among the studied population. A great emphasis on oral health education and some risk factor modifications are recommended.

Association between untreated carious lesions and asthma in adults at Rabat University Hospital, Morocco: a cross sectional study.

BACKGROUND: Depending on risk factors, cumulative risk of developing more dental caries by age has been reported. However, the association between dental caries and asthma is less studied among adults. The aims of this study were to evaluate the severity of untreated carious lesions in a population of asthmatic adults and to evaluate the mediation of socio-economic and oral health behaviour variables. METHODS: The study involved participants with diagnosed asthma (N = 100) and control (N = 100) subjects attending a tertiary hospital. Groups were matched by age and gender. Asthma was the exposure of interest. The outcome measure was the rate of carious lesions. Recorded variables included demographics, socio-economic status, tooth brushing habits and oral health status using WHO criteria. Poisson regression analysis examined the association between asthma and untreated dental caries. RESULTS: The adjusted model, after the inclusion of individuals' behaviours regarding oral health, social determinants and asthma, revealed a significant association between the number of untreated carious lesions and asthma (PR = 1.23; 95% CI 1.23-1.58; p < 0.001). CONCLUSION: Patients with asthma showed a greater number of untreated carious lesions. Looking forward, better understanding of the association between asthma and oral health may require exploiting the interactions of behavioural, social determinant and biological factors.

U-shaped association between untreated caries and body mass index in adults at Rabat dental University hospital, Morocco: cross sectional study.

BACKGROUND: Many previous studies estimating the relationship between body mass index (BMI) and dental decay are conflicting. Most studies, however, examine the relationship using BMI as a categorical variable. This study evaluated the non-linear association between body mass index as a continuous variable and untreated dental decay. METHODS: Cross-sectional study of adults free of diseases attending a tertiary dental clinic was conducted. The number of untreated caries at the time of consultation was assessed using the WHO criteria. A multivariable Poisson regression model for severity of untreated dental decay was first established. Restricted cubic spline functions were used to consider potential non-linear associations between BMI and untreated dental caries. RESULTS: After multivariable adjustment, the prevalence ratios (PR) for the number of dental decay remained significantly associated with the age at beginning tooth brushing (PR = 1.15, 95% CI 1.05-1.25), BMI < normal (PR = 1.66, 95% CI 1.30-2.12), BMI > normal (PR = 1.30, 95% CI 1.03-1.65), SDI (PR = 0.61, 95% CI 0.50-0.75) and GI (PR = 1.59, 95% CI 1.30-1.94). When BMI was evaluated as continuous variable, it exhibited a significant U-shaped pattern with the number of untreated dental decay both in univariable and multivariable analysis. CONCLUSION: The rate of untreated tooth decay was associated with both under- and overweight status.

Prevalence of apical periodontitis and factors associated with the periradicular status.

AIM: The present study aimed at assessing the prevalence of apical periodontitis and identifying the factors associated with apical periodontitis, particularly the influence of the quality of root canal fillings and coronal restorations on the periradicular status. METHODOLOGY: The study population consisted of adult patients, men and women, seeking routine dental care at the Endodontic Clinic in the school teaching hospital between September 2006 and July 2008. For each patient complete oral examination and periapical radiographs were made for pathological teeth. All teeth were assessed individually. AP was diagnosed according to defined criteria, other variables were root fillings, coronal fillings, trauma and caries. The odds ratio and 95% confidence interval were used to calculate the risk of apical periodontitis related to tooth-specific risk indicators on the presence of apical periodontitis. A multiple logistic regression model to control for confounders and to determine their independent association with apical periodontitis was used also. RESULTS: AP was detected on teeth (63.79%). The prevalence of apical periodontitis in root canal-treated teeth was 39.5%. Of the dental variables caries, trauma, inadequate root fillings and inadequate restoration were significantly associated with AP. CONCLUSION: The prevalence of AP in this study group was higher than in other populations. The probability of AP increased significantly after root canal treatment and coronal filling and was closely associated with the quality of the filling.

Behavior of NiTi in the presence of oral bacteria: corrosion by Streptococcus mutans.

The aim of this study was to investigate the electrochemical behavior of nickel titanium (NiTi) orthodontic wires in a solution containing Streptococcus mutans oral bacteria. In this article, we explain our choice of bacterial species before describing the culture process in artificial saliva and the precautions needed to prevent contamination by other bacteria. The electrochemical behavior of the alloy (NiTi) was analyzed electrochemically in Ringer sterile artificial saliva and in artificial saliva enriched with a sterile broth and modified by addition of bacteria. The electrochemical procedures chosen for this study were: free corrosion potential, potentiodynamic curves and impedance spectroscopy. In this way, we were able to show that the free corrosion potential of the NiTi in the Ringer solution increases with time and then stabilizes, thus passivating the alloy. We also demonstrated that colonization of the metal surface by bacteria triggered a drop in the free corrosion potential. The electrochemical impedance findings revealed no significant difference in NiTi behavior between the two media. Finally, we observed a slight difference between the two corrosion currents in favor of the bacteria-enriched solution, in which the NiTi underwent greater corrosion. These findings demonstrate the impact of acidogenic bacteria on corrosion behavior of the NiTi wires investigated. However, further research is required, notably incorporating longer immersion times in the two media.

Repair of untreated horizontal root fractures: two case reports.

To present two cases of root fractures which have healed spontaneously without any treatment? This article describes two untreated horizontal root fracture of the maxillary incisors. The fractured teeth were without any sign or symptom, and tested as vital to thermal and electric pulp test. These fractures were discovered during a routine full-mouth radiographic examination.