A Combined Approach for the Aesthetic Management of Stained Enamel Opacities: External Bleaching Followed by Resin Infiltration.

Stained enamel opacities are frequently encountered in dental practice. However, due to the risk of unaesthetic outcome, managing such lesions by resin infiltration techniques alone is not advised. Therefore, performing external bleaching before resin infiltration procedure is mandatory to eliminate stains from the hypomineralized lesions in order to aesthetically infiltrate them. In this work, we describe clinical cases in which external bleaching and resin infiltration techniques were used for managing stained enamel hypomineralized lesions related to traumatic dental injuries and molar incisor hypomineralization. Despite the fact that this approach has some limitations, it could be concluded that external bleaching associated with the resin infiltration technique shows promising results to aesthetically manage stained enamel opacities when the stain is totally removed after bleaching.

New Approach to Managing Onychophagia.

Onychophagia is defined as a chronic habit of biting nails, commonly observed in both children and young adults. This oral habit may lead to various medical and dental problems. To date, onychophagia is considered an unsolved problem in medicine and dentistry. In this paper we describe an exclusive nonpunitive fixed appliance utilizing a stainless steel twisted round wire bonded from canine to canine, in the mandibular arch, as a treatment of onychophagia. It was used successfully in young adult patients and maintained for a month. With 9-month follow-up the treatment has satisfied the patients' expectations which may eventually yield promising implications of this new treatment to similar situations.

[Mandibular osteitis on a periapical granuloma mimicking an osteosarcoma: a case report]. / Ostéite mandibulaire sur un granulome péri-apical faisant évoquer un ostéosarcome. A propos d'un cas Clinique.

Introduction: Osteitis is an inflammatory disease of bone tissue. Its clinical presentation varies according to the site, presence or absence of pus, duration and etiology. It represents one of the endo-periodontal diseases complication. We report the case of a mandibular osteitis having led to confusion with an ostesarcoma. Observation: A 13-year-old boy was referred to our department for a right low swelling with suspicion of mandible osteosarcoma. The lesion's evolution was 6 weeks. With the local aggressiveness and the speed evolution, the first diagnosis proposed was a mandibular osteosarcoma. Based on the clinical and radiological data established, the diagnosis of mandibular osteitis on a periapical granuloma was made and the treatment consisted on the causal tooth extraction with curettage of the periapical lesion associated to the prescription of macrolide (ERY®). The clinical follow-up was 6 weeks, a recovery with cessation of clinical signs were noticed. Discussion: The differential diagnosis facing the clinical context is an osteitis on a periapical inflammatory cyst and especially mandibular osteosarcoma. For the therapy, it's a 3 components treatment (etiology, medical and surgical) to obtain a recovery.

[Accidental injection sodium hypochlorite during endodontic therapy. Better understand to better manage]. / Injection accidentelle d'hypochlorite de sodium au cours d'un traitement endodontique. Mieux comprendre pour mieux gérer.

The high frequency of iatrogenic incidents during endodontic treatment is a source of stress for the practitioner. These incidents may occur during the different steps of a root canal treatment. During irrigation, extrusion of sodium hypochlorite beyond the apex is a rare but impressive accident. Sodium hypochlorite, is the most common irrigant used in modern endodontics, but when it comes in contact with the periapical tissue, it can cause complications ranging from mild discomfort to serious tissue damage such as the hematoma and hemato-emphysema. The aims of this article are to discuss through the presentation of two clinical cases: Etiological and predisposing factors; Signs guiding to suspicion of accidental injection of sodium hypochlorite. In this work, we focused on clinical keys that help the practitioner in better understanding this accident in order to prevent it or to manage it well when it occurs.

[Dental fluorosis: an epidemiological investigation in the area of Ouardanine in Tunisia]. / La fluorose dentaire: enquête epidémiologique dans la région de ouardanine en Tunisie.

In this work, we carried out a transverse epidemiological investigation about the oral health state of pupils in the Ouardanine area. The investigation concerned 300 fifteen-year-old pupils. An amount of fluoride was administrated within drinking water. Further studies, within few years, will be desirableto follow the fluorosis evolution in this area.

Prise en charge prothetique precoce de l'enfant atteint de l'amelogenese imparfaite

L'amelogenese imparfaite est une pathologie hereditaire qui se manifeste principalement par des anomalies de structure de l'email generalisees pouvant atteindre toutes les dents des deux dentures; temporaire et permanente. D'autres manifestations cliniques peuvent egalement y etre associees. Les restaurations prothetiques visent a retablir l'esthetique et a maintenir les fonctions masticatoires et phonetiques ainsi que la longueur d'arcade et la dimension verticale d'occlusion. Les autres objectifs sont de prevenir un eventuel traumatisme psychologique du a l'absence des dents et a l'apparition d'habitudes nefastes tels que l'interposition de la langue entre les dents; le maintien d'une deglutition infantile. Chez l'enfant; les traitements prothetiques comprennent; soit des restaurations prothetiques fixes (anomalies de structure; anomalies de forme); soit des restaurations prothetiques amovibles (agenesies; edentations partielle ou totale). Nous presentons le cas d'une patiente de 12 ans; atteinte d'une amelogenese imparfaite prejudiciable d'un point de vue esthetique. Les etapes de la realisation de restaurations prothetiques provisoires fixes et amovibles sont detaillees

An new concept for removal of dental fluorosis stains.

Bleaching has been suggested by several authors in order to treat the unaesthetic aspect of dental fluorosis. Many results are, however, unsatisfactory. A different method, based on the structural characteristics of the fluorotic tooth and the organic and exogenous nature of fluorotic enamel stains, includes three principal stages: 1--enamel etching with 12% HCl in order to eliminate the posteruptive calcified layer that covers the fluorotic enamel surface and to denude the microcavities containing the organic elements; 2--application of pure manufactured sodium hypochlorite to remove these organic stains; and 3--filling the chemically opened microcavities with a light-cured dental adhesive to provide the tooth with a smooth and even surface and to prevent restaining. To improve the aesthetic aspect of intensely discolored teeth, it is possible to use a variety of tints available in several composite resin kits. Teeth with a rough enamel surface react more positively than ones with a smooth surface. The enamel adhesives provide better results than the amelo-dentinal ones.