[Digestive pathology and oral condition in the rural populations of the Ferlo in Senegal]. / Pathologie digestive et état bucco-dentaire chez les populations rurales du Ferlo au Sénégal.

UNLABELLED: The aim of this work was to study the association between dental and periodontal status and digestive pathology in the Ferlo populations in Senegal. METHOD: This was a cross sectional study involving 300 people living in the area of the Ferlo in the Centre East of Senegal. Selected individuals must be over the age of 15 years and resided in the area. Cluster sampling helped recruit individuals. Collected information related to digestive pathology (yes or no), periodontal status (plate index, inflammation, bleeding, loss of attachment, the depth of pocket and the CPITN.) Dental status was evaluated by the DMFT. The data analyzed with software R and the Student's t test used to compare the averages of the indices in both groups at the threshold of 5%. Multivariate logistic regression analysis was used to isolate the final model with a threshold of 5%. RESULTS: Averages of dental and periodontal index were broadly equal in both groups (sick and not sick). The DMF and missing teeth were significantly associated with the digestive pathology after adjustment on gender, age, BMI, marital status, the number of cigarettes smoked and the depth of pocket. CONCLUSION: This study revealed a significant association between dental status and digestive pathology. The comprehensive care of patients therefore raises the interest of collaboration between surgeons, dentists and gastroenterologists for effective and adequate treatment.

[Relationship between menopause and tooth loss]. / Période de la ménopause, mortalité dentaire et facteurs systémiques.

This work proposes to evaluate the relationship between menopause and oral health by a cross-sectional study conducted on 202 menopausal women with or without hormone replacement therapy (HRT) and not menopausal women, with backgrounds socio-economic and socio-cultural variety and aged 42 to 80 years. Two hundred and two patients were the subject of an interrogation and a detailed clinical examination. Relations between menopausal and dental mortality were determined by bi and multi analyses varied. The result notes that the number of missing teeth is lowest among women from backgrounds socio - economic favored (p = 0.015). In addition, the number of missing teeth is highly correlated with dry mouth (p = 0,000). On the other hand, postmenopausal women on hormone replacement therapy have less missing teeth than postmenopausal women without hormone replacement therapy, (p = 0.02). In addition, the number of missing teeth is significantly increased in non-diabetic heart women, (OR = 1,215). This result is essentially the same in heart patient, non-diabetic postmenopausal patients without HRT, (OR = 1,214). Finally, we note a link between stressful events and dental mortality (p = 0.042).

[Lifestyles and oral health in Fulani populations of Ferlo in Senegal]. / Modes de vie et santé buccodentaire chez les populations peuhls du Ferlo au Sénégal.

BACKGROUND: The population of Ferlo consists mainly of Fulani, whose lifestyle is characterized by nomadism and cattle breeding. The aim of this work was to study their dietary, living, and hygiene habits and their oral health. METHODOLOGY: This cross-sectional study included 300 individuals living in Tessekere and Widou Thiengoli, in the heart of the Great Green Wall of Senegal. These individuals were selected by cluster sampling and had lived in the area for over fifteen years. The 1997 WHO questionnaire was used to collect data from interviews and clinical observations. Information was collected specifically about eating habits, lifestyle and hygiene, dental caries (DMF) and periodontal treatment needs (CPITN). The coefficients of determination and correlation were used to explain and identify significant associations (defined by a p-value <0.05). RESULTS: Milk was consumed by 96% of the population and tea by 90%;47% of the population smoked more than half a pack of tobacco a day, 11% drank "boulfalé" (Cologne water of 45°), and 88.6% used toothpicks for dental hygiene. Tooth cleaning frequency was negatively correlated with the DMF index and CPITN, and consumption of milk, fruit and cigarettes were positively correlated with the CPITN. CONCLUSION: Dietary factors, smoking and hygiene appear to influence the oral health of populations in Ferlo. Prevention programs should be established, focusing on simple information to induce behavioral change.

Characteristics and prediction of the alveolar bone loss: essay of modeling.

The alveolar bone loss is a phenomenon which intervenes throughout the life and which can be aggravated by the action of individual and behavioural factors. From this observation we shall try to characterize it and to propose formulas of prediction of the alveolar bone loss according to the age of the patient. We shall expose an analysis of factors bound to the alveolar bone loss and propose a modeling of the alveolar bone loss according to the age in an essentially predictive purpose. The methodology is based on the medical exploitation of CT-dentascanners and medical questionnaire as well as administrative questionnaire used in odontology. Measures of the distance ECJ and the summit of crest are made on the radiology and the individual factors and behavioural factors are scored. The descriptive analysis of the data allowed us to characterize the phenomenon of alveolar bone loss in a therapeutic purpose. The statistical treatment of these data will establish various models according to gender. The described method is simple and its applications seem numerous in the several domains: prevention, improvement of prosthetic and periodontal therapeutics.

Severity of periodontal disease correlates to inflammatory systemic status and independently predicts the presence and angiographic extent of stable coronary artery disease.

BACKGROUND: Periodontal disease (PD) has been recognized as a risk factor for systemic diseases, but its involvement in the pathogenesis of coronary artery disease (CAD) remains debated. OBJECTIVES: We sought to evaluate the potential relations between severity of the PD, inflammatory response and angiographic lesions extent in patients with stable CAD. DESIGN: A total of 131 subjects referred to our centre for coronary angiography were evaluated for presence and extension of CAD, then divided into two groups, one with presence of lesions (cases, n = 85) and other one with absence of lesions (controls, n = 46). Mean periodontal pocket depth (PPkD), high sensitivity C reactive protein (hs-CRP), serum amyloid A protein (SAA) and fibrinogen levels were measured in all patients. RESULTS: Cases and controls did not differ according to their baseline characteristics and prevalence of traditional cardiovascular risk factors. PPkD was greater in patients with CAD than in controls (2.24 +/- 1.28 mm vs 1.50 +/- 0.93 mm, P < 0.001 by Student's t-test). Systemic inflammatory response was more pronounced in cases than in controls, with higher values of hs-CRP, SAA and fibrinogen. Furthermore, PPkD values correlated with hs-CRP (r = 0.80, P < 0.001), SAA (r = 0.71, P < 0.001), fibrinogen levels (r = 0.72, P < 0.001) and the American College of Cardiology/American Heart Association angiographic score (r = 0.68, P < 0.001) in cases. Multivariate analysis indicated a persistent independent correlation between PPkD and angiographic score after adjustment for inflammatory markers levels. CONCLUSION: In the present study, PD lesions predicted presence of CAD stenosis in patients with cardiovascular risk factors. PD severity was correlated to angiographic extent of coronary lesions, independent of systemic inflammatory status. Those results suggest that these patients might benefit from an intensive periodontal therapy to prevent CAD progression.

[Care of handicapped children under general anesthesia in relation to different clinical parameters. Preliminary notes]. / Prise en charge des enfants handicapés sous anesthésie générale. Lien avec différents paramètres cliniques. Notes préliminaires.

Losses of teeth are significant and frequent among handicapped patients. For this study a sample of 58 children handicapped out of the 412 children dealt with for preserving dental care under general anaesthesia, was analyzed. If at equal age these children present a CAD on permanent teeth more significant, their undertake, the procedure of general anaesthesia and the preserving treatments under general anaesthesia do not present more difficulties than the child is handicapped or not. The factor determining in the effectiveness and the speed of the exempted acts seems to be the training of the dental care team.

[Care of handicapped children under general anaesthesia. Relationships with various clinical parameters. Preliminary notes]. / Undertake handicapped children under general anaesthesia. Link with various clinical parameters. Preliminary notes.

Losses of teeth are significant and frequent among handicapped patients. For this study a sample of 58 children handicapped out of the 412 children dealt with for preserving dental care under general anaesthesia, was analyzed. If at equal age these children present a CAD on permanent teeth more significant, their undertake, the procedure of general anaesthesia and the preserving treatments under general anaesthesia do not present more difficulties than the child is handicapped or not. The factor determining in the effectiveness and the speed of the exempted acts seems to be the training of the dental care team.

Oral functional characteristics and gastrointestinal pathology: an epidemiological approach.

One of the main problems for aged people is that of having a balanced diet, improved by correct conditioning of the alimentary bolus. Does the masticatory status influence the appearance of gastrointestinal disorders? Such a question justifies the present study. The present work concerned all the patients (211) of eight geriatric institutions, and was completed by a retrospective approach (case-control study). The main result brought by the case-control study, showed that poor oral functional characteristics represent a risk for gastrointestinal pathology (age being neutralized; odds ratio (OR): 2.62). This result indicates that the loss of teeth must be compensated by functionally effective dentures. Not only will the patients' physical and psychic health improve but also medical and public health problems will be solved.

Polymetallism and osseointegration in oral implantology: pilot study on primate.

In oral implantology, successful results in osseointegration are obtained in the medium term (6-12 months) with commercially pure titanium implants. However, current superstructures can be of a different nature (precious metal or titanium) and of different manufacture (cast or machine-produced). Polymetallism between the implant and the superstructure may lead to conditions of galvanic corrosion, and influence osseointegration. The study described establishes, on the one hand, the procedures of animal experimentation in primates and on the other, the techniques of analysis of histological sections. The first technique of analysis is based on histomorphometry and leads to the definition of an osseointegration index. The second technique of analysis consists of X spectrometry by dispersion of energy which enables a spectral analysis of selected points below the crestal neck of the implant (vulnerable area in the case of corrosive attack) to be obtained. It is noted that after 6months, two of which were of activation, osseointegration did not vary according to the nature of the superstructure (precious alloy or titanium). After 2 months, the presence of a precious alloy superstructure lead to titanium migration towards the area around the cervical region of the implant (10-50 microm). This phenomenon did not occur with a titanium implant. It can therefore be presumed that polymetallism leads to detectable corrosion after 2 months but without apparent modification of osseointegration.

A "case control" study on the rôle of HLA DR4 in severe periodontitis and rapidly progressive periodontitis. Identification of types and subtypes using molecular biology (PCR.SSO).

HLA DR4 antigens have been considered as a risk factor in periodontal disease. The aim of this "case control" study was to verify and to provide fuller clarification of such data. "Cases" or patients had to be aged between 20 and 48 years. They presented at least 5 sites spread over several teeth with an attachment loss equal or greater than 6 mm, and 10 sites spread over several teeth with periodontal pockets equal to or greater than 5 mm. Verification with a WHO probe showed an individual CPITN score of 4. Moreover, subjects whose average CPITN score for the 6 sextants was less than 3 were excluded from the study. Among these "severe periodontitis" patients, a subgroup was distinguished composed of subjects aged 20-35 years who presented, in accordance with the cases by Katz and co-workers, 5 or more teeth showing pocket depths of 6 mm or more. The dental chartings of these subjects showed an attachment loss of more than 3 mm on certain teeth over an inter-exam period of 1-3 years. They all displayed obvious loss of bony support in the affected sites. This constituted the "rapidly progressive periodontitis" subgroup. The "controls" were all over 20 years of age, and it was clinically verified that they were free of periodontal disease. There were 48 "cases" and 55 "controls". HLA typing of patients and controls was performed using "sequence oligoprobe hybridization after polymerase chain reaction" in accordance with the 11th International Workshop. This method allowed the detection of DR4 alleles as well as DR4 subtypes. The ethno-geographic origin of the subjects, considered as a confounding variable, was neutralized by stratified analysis. Subtypes 0401, 0404, 0405 and 0408 tended to be more frequent (p=0.08) in the cases (Severe Periodontitis). Focusing on analysis of "rapidly progressive periodontitis" in subjects aged 20-35 years, a very significant Mantel-Haenszel chi2 was obtained (p=0.0058) which led to a Mantel-Haenszel standardized odds ratio (OR) equal to 17. The 95% confidence interval was 1.03<0.R.<180.10. In conclusion, this supports previous reports and gives further clarification: in particular subtypes 0401, 0404, 0405 and 0408 can be considered as a risk factor for "rapidly progressive periodontitis". It should be noted that these determinants have been implicated in rheumatoid arthritis.

Speech intelligibility in patients with complete dentures according to the material used.

The principal purpose of this study was to investigate the speech of two edentulous subjects fitted with a complete maxillary prosthesis made of three different palatal materials: aluminium, resin, stellite. The study was performed using two speakers fitted with a prosthesis (a man and a woman). They took part in the acoustic recording of logatoms read by themselves while wearing various prostheses. These recordings were tested from the auditory point of view by a series of six listeners (four men and two women) in an anechoic room. After 144 different tests, a speech reception threshold (SRT) was defined for each speaker and each different prosthesis. This SRT shows a level of speech intelligibility defined so that the lower the SRT, the more intelligible for the listener. The results show that: (i) both the material and the listener influence SRT: (P < 0.05); (ii) an interaction between the material factor and the speaker factor appears. (P < 0.05); (iii) The hierarchy factors influencing SRT are most important in the order: Listener --> material --> speaker; and (d) The group fitted with a metal prosthesis (aluminium, stellite) was more intelligible regarding the way they were perceived by others.

Study of behaviour and endurance of Bioapatite implanted in the periodontium of the dog (closed model).

The principle purpose of this study was to quantify endurance of the biomaterial Bioapatite implanted in periodontal structures of the dog (closed model), such quantification being established by means of indices (Endurance Index and Transformed Endurance Index) obtained as a result of data-processed analysis of histologic images. The investigation further aimed at studying the development of new cementum and the reconstruction of an attachment system. The study was conducted on eight dogs and 222 sections. New cementogenesis and the reconstruction of an attachment system are observed both in the test sites and the reference sites. Endurance of the biomaterial is statistically linked with time: the most substantial decrease in the endurance is observed between two and six months. Traces of the material subsist at month 9. The structure of material masses always remains lacunal on a microscopic scale (highest average Endurance Index observed during the investigation: 30.35%). An osteoid deposit can be continually detected as of the second month around crystalline deposits. Further, this type of deposit was noted on the periphery of the deposits implanted in ectopic position in the supracrestal connective tissue.

[The effect of a formaldehyde-tyrothricin combination placed in periodontal pockets in association with scaling and root planing]. / Evaluation de l'activité d'une association "formaldéhyde-tyrothricine" instillée dans les poches parodontales en complement du detartrage-surfaçage.

A solution of formaldehyde and tyrothricin was placed in periodontal pockets of 14 patients. One maxillary quadrant was used as the experimental side, while the contralateral quadrant was employed as the control. A placebo solution was placed in the pockets of the control side. Both the experimental and control sides were treated on days -3, 0, +4, +7, +11 and +14. Scaling and root planing was accomplished on day 0. Plaque and gingival indices, and gingival fluid volume were recorded on all of the treatment days, as well as on day +28. Pocket depths were noted on days -3, 0, +14 and +28. Improvements were noted in all parameters measured on both the experimental and control sides, although statistical analyses revealed that plaque and gingival indices were slightly better in the experimental side. The author concludes that placing a Formaldehyde-Tyrothricin solution in periodontal pockets offers some therapeutic gain over scaling and root planing alone.

[Dye penetration of 3 temporary ready-to-use cements]. / Pénétration d'un colorant au niveau de trois ciments temporaires prêts à l'emploi.

Dye penetration following obturation of standardized access cavities with three different ready to use temporary cements was compared (Cavit G, Dentorit and Ciprospad). Leakage and dye penetration of the materials were simultaneously evaluated. Ciprospad appears to be the most adapted material.

[Experimental study of Vicryl used as a filling material. Preliminary note]. / Etude expérimentale du Vicryl employé comme matériau de comblement. Note préliminaire.

The combination VICRYL and bone wax is studied as filling material in periodontal locations in dogs. Histological studies were carried out at one, two, six and nine months. Bone formation is already quite marked at two months, and total at six months. A desmodont and a secondary cement are formed. At six and nine month, reattachment is excellent.

["Tooth mortality" in a Marseille S.C.T.D. The effect of periodontal disease: comparison with some results of a national epidemiological study]. / Etude descriptive de la "mortalité dentaire" dans un S.C.T.D. Marseillais. Impacts de la maladie parodontale; confrontation avec certains résultats d'une étude épidémiologique nationale.

1,247 avulsions have been noted for a year in the S.C.T.D. (tooth, age and sex of the patient). 44.6% were caused by tooth decay. However periodontal disease was responsible for 39.5% of tooth avulsions. The tooth lost because of periodontal disease were in most part extracted after 40 years. A weakness of some type of teeth regarding tooth mortality may be quoted. A sexual dimorphism of tooth mortality was present in the studied population.

The influence of gingival stimulation on recovery from human experimental gingivitis.

The present study concerns an investigation carried out to determine the effects of gingival stimulation on the resolution of a human experimental gingivitis. 10 young male dental students participated in the experiment. Following the baseline examination (day 0), the participants were instructed to abstain from all oral hygiene procedures during a 21-day period. Heavy plaque accumulation and gingivitis developed during the 21-day induction period. On the evening of the 21st day, active oral hygiene measures were reinstitued, for an 8-day period, using 2 different methods. For the left side of the maxillary arch, a hygiene procedure including gingival stimulation was prescribed. On the other hand, for the right side, a hygiene method without gingival stimulation was instituted. On both sides of the upper arch, the gingival condition was assessed by means of the gingival index, and soft deposits were assessed by the plaque index (selected teeth: 13, 14, 15, 23, 24, 25). Measurements were performed on days 0, 21, 22, 23, 24, 25, 26, 27, 28, 29. On day 29, ideal oral hygiene conditions and gingival health were re-established on both sides. However, a statistical analysis of the data collected during the recovery period revealed that gingival index scores were temporarily, but significantly, higher on the side where mechanical stimulation was performed, although plaque deposits there decreased more rapidly. Thus the present work supports the idea that gingival stimulation does not in any way improve recovery from experimental gingivitis.