Connaissances et attitudes face à la prise en charge des maladies parodontales nécrotiques : enquête auprès des chirurgiens-dentistes de Dakar (Sénégal)

Les maladies parodontales nécrotiques nécessitent une prise en charge rapide et efficace pour ne pas compromettre le potentiel de cicatrisation du parodonte. L'objectif de ce travail était d'évaluer les connaissances et attitudes des chirurgiens dentistes de Dakar face aux maladies parodontales nécrotiques. Matériels et méthodes. Il s'agissait d'une enquête transversale descriptive concernant les chirurgiens dentistes de la région de Dakar. L'étude a inclus les chirurgiens dentistes de la région de Dakar inscrits aux tableaux de l'ONCDS de 2015 et ceux du Service de Santé des Armées. Résultats. L'échantillon était constitué de 122 dentistes sur un total de 238 soit un taux de participation de 51,26%. La majorité des praticiens (39,34%) avait une durée d'exercice comprise entre 1 à 5 ans. La formation continue était suivie par 52,45 % des dentistes. La majeure partie (73,77 %) des chirurgiens dentistes ignoraient que les maladies parodontales nécrotiques font partie de la nouvelle classification des maladies parodontales. Concernant le traitement d'urgence de ces pathologies, 91,80 % des praticiens prescrivaient systématiquement des antibiotiques, 67,21 % faisaient une détersion des lésions avec des compresses et 55,74 % pratiquaient un débridement mécanique et irrigation à la polyvidone iodée pendant la phase aigue de la maladie. Conclusion. La prise en charge des maladies parodontales nécrotiques n'est pas toujours conforme aux recommandations scientifiques actuelles. Il convient de faire de la formation continue des chirurgiens dentistes du Sénégal, un impératif éthique et légal

[Prevalence of Helicobacter pylori detected by real-time PCR in the subgingival plaque of patients with chronic periodontitis]. / Prévalence d'helicobacter pylori détecté par PCR en temps réel dans la plaque sous-gingivale des patients atteints de parodontite chronique.

BACKGROUND: Helicobacter pylori plays a significant role in gastric disease. The aim of the present pilot study was to evaluate the prevalence of H. pylori detected by real-time polymerase chain reaction (real-time PCR) in the sub-gingival plaque of chronic periodontitis patients and to determine periodontopathogens profile of positive sites at H. pylori. METHODOLOGY: 109 subgingival samples collected from 17 subjects with chronic periodontitis were studied. The DNA was extracted from the oral samples and analyzed for the presence of H. pylori by real-time PCR (LightCycler) using 16S rRNA#120 primers which targeted the 16S rRNA gene. DNA from H. pylori DSM 4867 was used as a positive control. Seven bacteria implicated in chronic periodontitis were selected to explore the presence of these periodontopathic species in the oral positive sites for H. pylori. RESULTS: 16 of 109 samples (14.7%) were positives of H. pylori. All the positives sites were also positives to Fusobacterium nucleatum and Eikenella corrodens, 62.5% to Porphyromonas gingivalis, 31.25% to Treponema denticola, 25% to Prevotella intermedia, 12.5% to Aggregatibacter actinomycetemcomitans and 6.25% to Tannerella forsythia. CONCLUSIONS: H. pylori may be present in the subgingival plaque samples of patients with chronic periodontitis who are resident in a developing country. F. nucleatum and E. corrodens could coaggregate with H. pylori in the subgingival dental plaque.

[Evaluation of the need for periodontal treatment in prisons near Dakar, Senegal]. / Evaluation des besoins de traitements parodontaux chez les détenus de la région de Dakar (Sénegal).

INTRODUCTION: Oral diseases qualify as major public health problems due to their high prevalence and incidence. They usually affect poor and marginal segments of the population. This study focused on the prison population that is characterized by poor living conditions and malnutrition. The aim of study was to assess the need for periodontal care in prisoners serving time in the Dakar region of Senegal. METHODS: This cross-sectional study included 375 prisoners serving in three facilities, i.e. the penal camp, Liberte VI prison for women, and Rufisque prison for women. Data were collected using a modified WHO information sheet. The community periodontal index of treatment needs (CPITN) was used for scoring. Statistical analysis with stratification by sex and age was performed and tests were considered as significant for p < or = 0.05. RESULTS: There were 335 men (89.3%) and 40 women (10.7%) with a sex ratio of 8.3. Mean age was 35 years +/- 11.5 (range, 16-88). Mean prison time was 39.29 months +/- 17.73. The proportion of prisoners needing periodontal treatment increased gradually according to prison time with significant differences (p < 0.05) even after stratification. CONCLUSION: Better management taking into account the environment and prison time would reduce the need for periodontal treatment in prisons in Dakar.

[Periodontal treatment needs in prisoners in the region of Dakar (Senegal)]. / Besoins de traitements parodontaux chez les détenus de la région de Dakar (Sénégal).

INTRODUCTION: Oral diseases qualify as major public health problems, because of their high prevalence and incidence. They usually reach the poor and socially marginalized populations. This study looked at the prisoner's population who is characterized by precarious conditions. Thus the aim of this study was to assess periodontal treatment needs in prisoner's population of Dakar. METHODOLOGY: This was a cross sectional study which interested 375 prisoners living in camp penal, in Prisons for Women in Liberte VI and in Rufisque. The data were collected by a modified WHO sheet. The indicator of periodontal treatment needs (CPITN) was used. Statistical analysis with stratification by sex and age was performed and the tests were significant for p < or = 0.05. RESULTS: They were 335 men (89.3%) and 40 women (10.7%) with a sex ratio of 8.3. The age mean was 35 years +/- 11.5 with a maximum of 88 years and a minimum of 16 years. The mean stay was 39.29 months +/- 17.7. The proportion of prisoners with a periodontal treatment need increased gradually according to the prison stay with significant differences (P < 0.05) even after stratification. CONCLUSION: A more developed and taking into account the environment and the prison stay would reduce the periodontal treatment needs in prisoner's population in Dakar.

[Periodontal status of Senegalese patients with Sjögren's syndrome. A case control study at the Service of Internal Medicine]. / Santé parodontale et syndrome de Gougerot Sjögren. Etude cas-témoins au service de médecine interne.

The aim of this study is to compare the periodontal status of patients with Gougerot-Sjögren syndrome (GSS) to healthy subjects in order to investigate the relation between periodontal disease and GSS. To achieve this aim, one hundred and three patients, among whom 36 with primary GSS and 67 with secondary GSS, were selected and compared with one hundred and three (103) control subjects. The hygiene level was evaluated with Silness and Löe plaque index (PI) and inflammation level with Löe and Silness gingival index (GI). Probing depth and clinical attachment loss was measured with Williams periodontal probe. Mean plaque indices were identical for both groups (1.27 +/- 0.1 versus 1.22 +/- 0.1, p = 0.67). Compared with control subjects, the inflammation index scores were significantly higher among SSG patients (IG = 1.1 +/- 0.1 versus 0.44 +/- 0.2, p < 0,001). The logistical regression model applied to the whole sample showed that patients with GSS had a higher risk of developing periodontal disease (IG : OR 5.508, state 95% CI [1.66-9.60] ; PP : OR = 4.51 95% CI [1.692-12.024]). A training program for GSS patients seems essential, in order to manage the deleterious effects of defective oral-dental ground. It would allow convincing patients about the interest of prevention through regular surveillance and care.

[Periodontal status in a sample of Senegalese women using hormonal contraception]. / Etat parodontal d'une population de femmes Sénégalaises sous contraception hormonale.

Hormonal contraception is based on the use of synthetic hormones containing variable doses of oestrogen and progesterone making it possible to avoid pregnancy in a temporary and reversible way. The objective of this study is to evaluate the periodontal status of a sample of Senegalese women under hormonal contraceptive. One hundred women using contraception since at least 6 month were paired on the age, the socio-economic profile and oral hygiene with a control group. Oral hygiene (plaque index (PI) of Silness and Löe), the inflammation (gingival index (GI) of Löe and Silness), probing depth and clinical attachment loss were recorded. With equal hygiene, the scores of the gingival index were significantly higher among women under contraceptive (p < 0.001). Inflammation was significantly more marked for the women who used contraception in injectable form compared to the control group (p < 0.001). Probing depth (3.01 +/- 0.04) and clinical attachment loss (3.19 +/- 0.08) were significantly more important among women under contraceptive (p < 0.001). The women under contraceptive seem to set up a group at risk for developing a periodontal disease, it is thus necessary to systematise periodontal appraisal before and during contraceptive use period.

[Periodontal conditions in young sickle cell anemia Senegalese patients]. / Etat parodontal du jeune sénégalais drépanocytaire homozygote.

INTRODUCTION: The oral cavity holds a complex microbial flora including periodontal pathogens. The infectious complications are common in sickle cell anaemia, which reaches 1% of the population in Senegal. The objective of this study is to assess periodontal conditions in young Senegalese sickle cell anaemics. PATIENTS AND METHODS: A sample of 82 subjects aged between 15 and 34 years with mean at 25.2 years +/- 4.6 was made up, including 35 homozygous and 47 non homozygous. Plaque index, gingival index and papillary bleeding index, tooth mobility and clinical attachment loss were assessed. Partial correlation between periodontal indexes and haemoglobin and hematocrit controlling for plaque index was performed. RESULTS: No significant statistical differences were found for periodontal indexes and clinical attachment loss between the two groups, even if homozygous show higher values. Periodontitis is less frequent in homozygous and odd ratio show protective effect of sickle cell anaemia (OR = 0.381, IC at 95% = [0.130; 1.1 18]). Tooth mobility is significantly increased in homozygous with mean at 1.0 +/- 0.8 versus 0.5 +/- 0.4 in control group (p = 0.000). Partial correlation show significant negative association between haematocrit and papillary bleeding index in homozygous (p = 0.045). CONCLUSIONS: The hypothesis that sickle cell anaemia can affect periodontal conditions and worsen periodontal diseases is to be considered even if it has not been proved as risk factor. Increased tooth mobility could be marker of periodontal risk in homozygous.

[Influence of orthodontic anomalies on periodontal condition]. / Influence des anomalies orthodontiques sur l'état parodontal.

INTRODUCTION: Three main reasons are routinely cited to justify the provision of orthodontic treatment: improvement of facial and dental aesthetics and of dental health and function. However, association between malocclusions and periodontal condition is still controversial. The aim of the present study was to further investigate the correlation between certain orthodontic anomalies and periodontal condition. MATERIALS AND METHOD: One hundred and one subjects were included in this study. Information regarding oral hygiene habits and accessibility to professional oral health care were obtained from each subject. Malocclusions were assessed with the Indice of Orthodontc Treatment Need (IOTN) and the Index of Complexity, Outcome and Need (ICON) and periodontal with the Community Periodontal Index for Treatment Need (CPITN). Spearman Rank correlation order was used to test for any association between malocclusions and periodontal condition. Significance was set at the 5% level. RESULTS: Contact point displacements (malpositions) are positively and significantly correlated to CPITN in the mandibular arch. There was also significant negative correlation between spacing and CPITN in the maxilla. Openbite and overjet assessed by IOTN have a significant positive correlation with the periodontal condition as assessed by the CPITN. In contrast no correlation was found with dental crossbite (IOTN and ICON). At last, there was significant correlation between overbite and periodontal condition. CONCLUSION: Significant correlations were found between malocclusions and periodontal condition. Within the limitation of this study one can suggest that malocclusions are risk marker for periodontal diseases. However, this study by virtue of its protocol cannot allow us to makeany inference about a cause/effect relationship between malocclusions and periodontal condition.

[Treatment of localized gingival hypertrophy induced by orthodontic appliances using modified Widman flap. A case report]. / Traitement de l'hypertrophie gingivale localisée associée au port de dispositifs orthodontiques par lambeau de Widman modifié. Rapport de cas.

Gingival enlargement is a condition that commonly develops during orthodontic treatment. Orthodontic appliances are irritation and retention plaque factors holding up oral hygiene and control of gingival inflammation. This case-report shows localized gingival hypertrophy in young Senegalese female undergoing orthodontic treatment with fixed appliances. Modified Widman flap associated with osseous recontouring have led to morphological conditions of gingiva allowing better plaque control and orthodontic treatment going on. Comfort and controlled haemostasis after periodontal surgery make this procedure a good choice for treatment of gingival hypertrophy. Collaboration between orthodontist and periodontist is required for successful therapeutic.

[Periodontal status and diabetes: evaluation of 80 patients with diabetes mellitus in Conakry Teaching Hospital]. / Evaluation de l'etat parodontal au cours au diabète : a propos de 80 patients au CHU Donka de Conakry.

INTRODUCTION: Dental and periodontal diseases are frequent in diabetics. Few studies were carried out on oral pathologies of the diabetics in Africa. The objective of this study was to assess periodontal conditions in a population of diabetics followed in a hospital environment by comparing them with non diabetics. PATIENTS AND METHOD: In a cross-sectional study realized from January to April 1999, 80 diabetic patients followed in the Service of Endocrinology were compared to 35 non-diabetic patients, chosen among the patients attending in the Service of Internal medicine of the Donka Teaching Hospital in Conakry in the same period. Both groups were compared according to the simplified oral hygiene index (OHIS) and community periodontal index of treatment needs (CPITN). RESULTS: There was no difference between diabetics and nondiabetics according to the OHIS. Diabetics CPITN index was higher compared to non-diabetics (p = 0.019). In diabetics, scores of CPITN increase significantly with duration of diabetes mellitus (p = 0.019). Also correlation was found between OHIS and the duration of diabetes. Glycemic control was significantly correlated with OHIS (p < 0.001) and CIPTN (p < 0.001). CONCLUSION: Diabetic patients have more periodontal treatment need than controls. Better collaboration between diabetologist and odontostomatologist is needed to preserve the oral health of diabetics.

[Gingival hypertrophy during orthodontic treatment: contribution of external bevel gingivectomy. Case report]. / L'hypertrophie gingivale au cours du traitement orthodontique: apport de la gingivectomie à biseau externe. Rapport de cas.

Gingival enlargement is a condition that commonly develops during orthodontic treatment. Orthodontic appliances are irritation and retention plaque factors holding up oral hygiene and control of gingival inflammation. Two cases of gingival hypertrophy in young Senegalese females undergoing orthodontic treatment with fixed appliances are described and treated by gingivectomy. This surgical procedure have led to morphological conditions of gingiva allowing better plaque control and the orthodontic treatment going on. Periodical controls in child and adolescent are required for healthy periodontium during orthodontic therapy. Collaboration between orthodontist and periodontist is one of the most important keys to successful treatment.

[Evaluation of gingival condition in homozygous children and adolescents with sickle cell anemia in Senegal]. / Evaluation de l'etat gingival chez l'enfant et l'adolescent drepanocytaires homozygotes au Senegal.

Sickle cell anaemia is an inherited disorder of haemoglobin synthesis leading to haemolytic anaemia. It touches more than 50 million people in the world and 10% of the population in Senegal. Only the homozygous form is symptomatic and appears by painful crises of vaso-occlusive type. There is a lack of works carried out or published in Senegal about potential link between periodontal conditions and sickle-cell anaemia. The main objective of this study is to assess the gingival conditions in Senegalese children and adolescents homozygous sickle cell anaemic. Secondary, the gingival state is correlated with oral hygiene and rate of reticulocytes to determine their relationship. Fifty homozygous attending the Albert Royer Paediatric Hospital of Dakar and unscathed of other systemic pathologies, were examined. The patients are old between 3 and 16 years with an average age 9.4 years +/- 3.8. The gingival state is assessed by measurement of the gingival index (GI) and index of sulculary bleeding (SBI). Partial correlation is performed between the two indexes and average of reticulocytes. The gingival index mean is 1.7 +/- 0.6 and 66% of the patients present a severe inflammation, which is more frequent in the age bracket from 3 to 12 years. The SBI mean is 1 +/- 1.1 and 68% of the patients present gingival bleeding, which is moderate to severe in 18%, with a greater frequency in the age bracket from 13 to 16 years. Strong correlation is found between plaque index, GI and SBI. Damage of gingival state seems not to be linked to the high average of reticulocytes controlling for oral hygiene. Children and adolescent homozygous have an inflammatory periodontium associated to poor oral hygiene, which highlights their needs in periodontal treatments. Early tracking and preventive treatment of periodontal diseases during systematic oral visits must be required.

[Surgical and Orthodontic Treatment of Impacted Canines: A Clinical Report]. / Prise en charge chirurgicale et orthodontique de canines incluses : rapport d'une observation clinique.

Impaction of tooth can be defined as a failure of a tooth to emerge usually due to insufficient space or the presence of a supernumerary tooth blocking its path of eruption. Impaction of the canines deserves particular attention due to their importance regarding occlusal stability and aesthetic. A case of a young girl who presented with an impaction of both upper canines and the lower left canine is reported here. Good therapeutic results have been obtained after 18 month of treatment with a multidisciplinary team involving oral surgeons, periodontists and orthodontists.

Parodontites et maladies respiratoires au centre hospitalier national universitaire de Fann (Sénégal)

Introduction : Les parodontites sont des pathologies infectieuses associées à différentes maladies générales dont les pathologies respiratoires. L'objectif de ce travail était d'évaluer la distribution des parodontites chez les sujets atteints d'affections respiratoires en milieu hospitalier. Matériels et méthodes : Il s'agissait d'une étude descriptive transversale basée sur un recrutement de patients hospitalisés ou venus en consultation au Service de Pneumologie de l'hôpital Fann. Les patients atteints de tuberculose n'ont pas été inclus. La distribution de l'atteinte parodontale a été évaluée par les mesures des profondeurs de poche (PP) au sondage et la perte d'attache clinique (PAC) à l'aide de la sonde parodontale de Williams. Résultats : Un échantillon de 70 patients dont 25 femmes et 45 hommes a été sélectionné pour cette étude. La moyenne d'âge était de 42 ans ± 4,2.La prévalence des pneumopathies bactériennes était de 54,3%, celle des Broncho Pneumopathies Chroniques Obstructives (BPCO) de 22,9%. Des profondeurs de poche ≥4mm ont été retrouvées chez 50% des sujets et 64,7% ont présenté une perte d'attache clinique ≥2mm.Les profondeurs de poche étaient plus importantes chez les patients atteints de pneumopathie bactérienne et de BPCO. Conclusion : La prévalence élevée des parodontites nécessite une collaboration entre pneumologue et parodontologiste afin de limiter les effets délétères d'une mauvaise condition orale sur la santé générale

[Perceptions and behavior toward dentistry in students and non-students in Dakar (Senegal)]. / Perceptions et vécus de l'art dentaire chez des etudiants et des non-etudiants a Dakar (Sénégal).

The authors try to appreciate the perception by student and non student population of dental care throughout fear of dentist, pain and dentist-patient relationship, also the patient preventive attitude. Results show more fear of the dentist by students and expressed pain. Dental cares are expensive according both students and non students but seem to be comfortable. Dentist-patient relationship is more appreciated at the Odontologic Institute which form future dentists and 80 per cent of patients consult for prophylactics care against 29 at the medico-social centre of the university. Dental care accessibility in developing country is a real problem and rate of dental diseases cannot be taken down without support of information and communication waves.

[Periodontal infection in pregnant women and low birth weight babies]. / Infection parodontale de la femme en etat de grossesse et faible poids du bebe a la naissance.

Among several factors in preterm low birth weight, we can find pre-conceptional causes and others depending on pregnant women's behaviour. In 1996 a scientific team composed by periodontists, gynaecologists and epidemiologists found that 18% of preterm low birth weight in 250,000 babies are due to periodontal infection. In our survey we used 113 pregnant women in gynaecological clinic in university hospital. By using Community Periodontal Index Treatment Needs (CPITN) in pregnant woman and by weighting babies as soon as accouchement done. In spite of percentage of preterm low birth weight, we registered 33.9% babies of normal birth weight with mother's CPITN under 1.