Irrigation endodontique à l'hypochlorite de sodium : Types de solutions et modalités de préparations dans 102 cabinets dentaires de la ville d'Abidjan (Côte d'Ivoire)

Introduction : L'hypochlorite de sodium (NaOCl) représente à ce jour le "gold standard" pour l'irrigation endodontique. L'objectif de cette étude était d'identifier les solutions de NaOCl utilisées comme irrigant canalaire et les modes de préparations dans les cabinets dentaires. Matériels et méthodes : Une étude prospective a été réalisée dans 102 cabinets. Par la suite, les teneurs en chlore actif (c.a.) des solutions de NaOCl ont été évaluées par titrage iodométrique. Les analyses statistiques ont été effectuées par le logiciel SPSS version 22 sous Windows (SPSS Inc., Chicago, IL, USA). Résultats : Les sources commerciales de solution de NaOCl étaient utilisées à 72,5% pour l'irrigation endodontique. Ces solutions étaient concentrées à 2,53% c.a. ou 3,80% c.a. selon l'emballage. Dans l'ensemble, les titrages iodométriques ont révélé des rétrogradations en c.a. des solutions mères. Les dilutions au 1/5ième étaient généralement réalisées, ce qui signifiait une concentration à 0,5% c.a. pour l'irrigation endodontique. Une solution de NaOCl stabilisée à 0,5% c.a. et disponible en officine était principalement utilisée dans les cabinets privés. Discussion : Les concentrations des solutions de NaOCl pour l'irrigation en endodontie se situe entre 0,5% et 6% d'après la littérature. Cependant un compromis semble être trouvé autour des valeurs situées entre 2,5% c.a. et 3% c.a. Dans ce cadre, les solutions de NaOCl issues du commerce dans cette étude peuvent être considérées comme prêtes à l'emploi. Il faut cependant tenir compte de leur instabilité qui suggère des préparations finales à teneur en c.a. inférieure à la minimale préconisée en endodontie (0,5% c.a.). Conclusion : cette étude montre l'intérêt de l'usage de solutions de NaOCl stabilisées et conçues spécifiquement pour l'irrigation endodontique. Ce sont elles qui sont considérées comme dispositif médical par les autorités sanitaires

Health-related quality of life improves during one year of medical and surgical treatment in a European population-based inception cohort of patients with inflammatory bowel disease--an ECCO-EpiCom study.

BACKGROUND & AIMS: Health-related quality of life (HRQoL) is impaired in patients with Inflammatory Bowel Disease (IBD). The aim was prospectively to assess and validate the pattern of HRQoL in an unselected, population-based inception cohort of IBD patients from Eastern and Western Europe. METHODS: The EpiCom inception cohort consists of 1560 IBD patients from 31 European centres covering a background population of approximately 10.1 million. Patients answered the disease specific Short Inflammatory Bowel Disease Questionnaire (SIBDQ) and generic Short Form 12 (SF-12) questionnaire at diagnosis and after one year of follow-up. RESULTS: In total, 1079 patients were included in this study. Crohn's disease (CD) patients mean SIBDQ scores improved from 45.3 to 55.3 in Eastern Europe and from 44.9 to 53.6 in Western Europe. SIBDQ scores for ulcerative colitis (UC) patients improved from 44.9 to 57.4 and from 48.8 to 55.7, respectively. UC patients needing surgery or biologicals had lower SIBDQ scores before and after compared to the rest, while biological therapy improved SIBDQ scores in CD. CD and UC patients in both regions improved all SF-12 scores. Only Eastern European UC patients achieved SF-12 summary scores equal to or above the normal population. CONCLUSION: Medical and surgical treatment improved HRQoL during the first year of disease. The majority of IBD patients in both Eastern and Western Europe reported a positive perception of disease-specific but not generic HRQoL. Biological therapy improved HRQoL in CD patients, while UC patients in need of surgery or biological therapy experienced lower perceptions of HRQoL than the rest.

[Evaluation of crown-root restorations in non-vital teeth. Survey of dentists in the city of Abidjan]. / Evaluation de l'utilisation des restaurations corono- radiculaires foulées: enquête réalisée auprès des praticiens de la ville d'Abidjan.

Coronal-radicular restoration is the coronal reconstruction of an endodontically treated tooth, with a support on and in the root. The objective of this study is to assess the importance of the carried coronal-radicular restorations in the dental practice in Abidjan. It is about a prospective survey of 100 dental surgeons practicing in the city of Abidjan, pulled at random. The information was collected through a self-interview. As results, 79% of our population knows and performs coronal-radicular restorations especially in the absence of 3 dental walls but at a very low, less of 5/month for 90% of this population. The protocol of realization seems well known and followed for the majority of the pooled practitioners. However, we deplored often absence of radiography in the protocol and also the exclusive use of metal posts. In conclusion, the coronal-radicular restorations are much used in the daily practice in Côte d'Ivoire. The protocol for achieving this type of restoration seems well known and followed by the practitioners according to our study. However, as material all the dentists are still in the screw post (metal post). The adhesive technologies using fiber posts don't seem accessible to our people.

Nano-odontology: nanostructured assemblies for endodontic regeneration.

The vitality of the pulp is so fundamental to the functional life of the tooth that new strategies are required to avoid the removal of the whole pulp following irreversible pulpitis and to regenerate the lost endodontic tissues. Nano-odontology would provide suitable solutions for pulp tissue conservative and regenerative approaches. In our group, we have shown that when covalently coupled to Poly-Glutamic Acid (PGA) the incorporation of an anti-inflammatory hormone (melanocortin, a-MSH) into the multilayered films Poly-L-Lysine (PLL)/PGA increases the anti-inflammatory reaction of pulp fibroblasts and macrophages stimulated by LPS (Lipo-Polysaccharides). Recently, usual linear PLL polymers have been chemically grafted for making new Dendrigraft polymers (DGLG4) whose higher branching ratios can give useful properties. The objective is to use nanostructured assemblies containing DGLG4 and PGA-alpha-MSH to design a new nanomaterial. These nanostructured assemblies (DGLG4-PGA-alpha-MSH)n constitute a thick reservoir of the anti-inflammatory peptide and promote adhesion and proliferation of pulp fibroblast on the biomaterial surface. These nanostructured films could be adapted for an endodontic regeneration application to target pulp connective tissue regeneration. Firstly, the crucial reduction of inflammation could be helpful by using PGA-alpha-MSH and secondly the initiation of the regeneration of the connective tissue will be promoted by the whole nanostructured film of which allows pulp cells colonisation.

[Survey of general dental practitioners in Abidjan on the use of the operatory field in dentistry]. / Enquête auprès des omnipraticiens d'Abidjan sur l'utilisation du champ opératoire en dentisterie.

Rubber dam is a standard operatory field in operative dentistry and endodontics. It is undoubtedly the most certain way to insure the success of therapeutics acts. Its use by Abidjan practitioners has been the subject of our study which aim is to underline the place of rubber dam in daily practice. Our investigations show that rubber dam is totally absent from practitioners acts. Generally cotton rolls constitute the most frequent mean used by practitioners to isolate the tooth in operative dentistry and endodontics. Only 23.9% of them associate saliva sucking up. Some cases of aspiration and swallowing file by accident by patients have been highlighted. Those results lead us to recommend the systematic use of rubber dam as the mean of efficiency and security which cannot be ignored in our practice.

[Dental amalgams and mercury polemic in Abidjan]. / Amalgames dentaires et polémique mercurielle à Abidjan.

Dental amalgam is metallic biomaterials which has raised a number of controversies in the past few years, because of mercury potential toxicity. Considering the significance of theses controversies, this study was carried out with a view to evaluating the behaviour of Abidjan-based practitioners with respect to dental amalgam. The contemplated objective is to determine the frequency in the use of dental amalgam, to identify the problems encountered using dental amalgam and to propose solutions for fighting mercury contamination. The results show that dental amalgam is used in 81.8% for posterior teeth restoration. The side effects mentioned are metallic taste, gingival tattoo, galvanic corrosion and tooth pain. This is why 21.8 % of practitioners believe that the controversy over dental amalgam has merits while 45.5% hold the contrary opinion because of lack of scientific arguments. However, considering the absence of means to treat amalgam waste, dentist practitioners and authorities have to get involved to fight against mercury contamination.

[Management of dental records: an example of the Department of Restorative Dentistry of the School of Odonto-Stomatology in Abidjan]. / Gestion de la fiche dentaire: exemple du service d'odontologie conservatrice de la Faculté d'Odonto-Stomalogie d'Abidjan.

The patient's file is often mismanaged because of the crowd and the frequency of emergencies caused by pain. The practitioner is worrying about handling it in first place. The objective of this work is to recall the importance of a good management of the dental records and to suggest a charting system. The interest of the dental chart, fundamental part of the patient dental file, is described before developing the implications related to an adequate management. The charting system of the service of Operative Dentistry and Endodontics of Abidjan Dental school is described. It translates the target of a good dental records management, which presents appreciable assets for practitioner, patient and administration.