Active and inactive caries lesions in a selected elderly institutionalised French population.

Various epidemiological investigations have shown the high prevalence and incidence of caries in geriatric populations. The aim of the present study was to evaluate the dental status and some salivary parameters of elderly French subjects institutionalised in a geriatric hospital. The study population included 117 subjects (31 males and 86 females) who were neither demented nor edentulous, with a mean age of 83.0 years (SD = 7.8). Crown and root caries were recorded according to a modified caries activity index on 17,442 surfaces (9 surfaces per tooth: 5 crown surfaces and 4 root surfaces). The 17,442 surfaces examined corresponded to 1,938 teeth. The mean number of teeth per subject was 16.6 (SD = 7.6), more teeth remaining in the mandible than in the maxilla. The 2,985 unsound root surfaces showed a high percentage of active lesions (31.2 per cent) and a low percentage of filled root surfaces (4.5 per cent). Crowns and roots also presented a high percentage of destroyed surfaces: 1,446 destroyed surfaces, 8.3 per cent of the examined surfaces. Salivary parameters (flow rate and buffer capacity) were also recorded. Stimulated salivary flow rate had a relationship with crown caries (linear regression and analysis of covariance), and buffer capacity with root caries (analysis of variance and covariance). The data illustrate critical treatment needs in French geriatric institutions. This situation, which appears to differ from previous reports in European and US elderly people, may be related to French specificities concerning oral health status and/or care policy, but also to the usually very old population.

A simple technique for age estimation in adult corpses: the two criteria dental method.

A method for age determination of adults from single rooted teeth is presented. It is based on the measurement of two dental features: periodontosis height times 100/root height (P) and transparency of the root height times 100/root height (T). These measurements are made on the labial surface of the entire tooth without section and do not require special equipment or training. The application of multiple regression analysis to a working sample of 306 teeth of known age, sex and race provided the following equation: Age (years) = 0.18 x P + 0.42 x T + 25.53. The mean error between the actual and estimated age was +/- 10 years on the working sample and +/- 8.4 years on a control sample made of 45 forensic science cases. Upper incisors showed a better precision than the other single rooted teeth and accuracy was not sex related. A comparison of the Gustafson and Lamendin methods on a control sample of 39 teeth resulted in an advantage of the latter considering the mean error on the estimation (14.2 +/- 3.4 years for Gustafson versus 8.9 +/- 2.2 for Lamendin). The Lamendin method can be practical interest for any forensic pathologist or dentist as it is fast, easy to use, and reasonably accurate except for cases of individuals under age 40 where other methods must be preferred.

[A practical method for the surgical uncovering of a buried implant]. / Méthode pratique de dégagement chirurgical d'un implant enfoui.

This method puts forward a new and easy process to uncover an endosseous implant before the prosthetic rehabilitation. We use a "punch", a dermatologist's instrument, composed of two parts: a plastic handle and a cylinder blade. We choose the diameter's blade instrument according to the diameter of implant and we change the punch for each implant to clear. The punch is held like a pencil, vertically. The punch goes deep into the gum to the bone and is turned simultaneous. A perfect cylinder part of gum is filled out. In case of propitious circumstances, this method is safe quick and avoids doing a second flap.

[A practical method for the determination of the available bone height in oral implantology]. / Méthode pratique de détermination de la hauteur osseuse disponible en implantologie orale.

This method puts forward a new and quick process to fix the available height of bone in the recipient site of an endosseous implant. With a flexible strip containing a lot of small equidistant gauged steel spheres, we can quickly reckon up the height of bone. The strip having been placed in the mouth, the patient bites it during the panoramic X-ray examination. The diameter of the spheres is known. On the X-ray photography we can easily measure the spheres and then reckon the available height of bone in the recipient site. This method presents many advantages: the anatomical conditions in the recipient site (specially the height of bone) are known very quickly, in case of contra-indication, this method gets the practitioner out of prescribing new X-ray examinations. So we consider that it is an economical process, an X-ray examination is always realizable with the strip. It is an easy work comparing with TDM.