Predictive factors for alveolar fenestration and dehiscence.

The purpose of this study was to evaluate the distribution and incidence of two forms of alveolar bone resorption known as fenestration and dehiscence across time and space. To accomplish this a Medieval French population was studied and the results were compared with other studies to examine incidence and distribution of alveolar bone resorption. Thus, 1175 teeth were analysed for 81 individuals, from an agropastoral Medieval (12th-14th century) archaeological site of Vilarnau located in the South of France. Tooth presence and absence as well as dental alveolar resorption were recorded. A new standardised methodological approach to record alveolar resorption is presented and can be used for any skeletonised series. Measurements of dehiscence were made in the midline on each root in relation to the cemento-enamel junction and fenestration was considered as resorption restricted to alveolar bone. Through analyses of the distribution and incidence of alveolar bone resorption over-time in a Medieval French population, along with nine other studies, we present a list of predictive factors for alveolar bone resorption. Among these factors tooth position and function were the most important; anterior teeth were more commonly affected, bone resorption was more common on the labial/buccal versus palatal/lingual surfaces, fenestration was also more common on the maxilla and dehiscence on the mandible (p≤0.001). These patterns do not vary through time or space, and therefore, provide predictive factors for health practitioners in oral therapy to improve patient recovery and post oral treatment success.

Topographical presentation of dental wear as arches in a French mediaeval population.

UNLABELLED: The diversity of notation systems for recording dental characteristics and the means used to display them makes comparisons and interdisciplinary collaboration difficult. OBJECTIVE: The aim of the present study is to propose the use of a method employed by experts worldwide but which may be new to bioarchaeologists. Since 1971 we have used the International Dental Federation (FDI) system, which provides the location of dental characteristics and the morphotype of each tooth at the same time, thus avoiding the need to specify upper or lower, and right or left to state the tooth position in the dental arch. DESIGN: To demonstrate the use of the FDI system, we applied it to the study of dental wear in a mediaeval Mediterranean skeletal sample from France consisting of 58 paired mandibles and maxillae belonging to 29 female and 29 male adults and divided into two age groups: young or aged 20-30 years, and mature or aged over 30 years. Tooth wear was recorded according to Brabant's index, which consists of four levels and four directions. Data were displayed in the form of curves, according to the FDI and taking age and sex into account. RESULTS: Analysis of the results shows a tooth wear distribution that is significantly different between upper and lower horizontal and oblique directions in females and males, and between upper and lower horizontal and oblique heavy wear in females and males. Moreover, a significantly asymmetrical horizontal and oblique distribution of wear was found in the young adult group. Thus, the use of criteria defined by precise reference points for recording data, and displaying results in the form of curves, makes comparison using superimposition easy and reliable and permits a more objective study of tooth wear. CONCLUSIONS: Furthermore, using a notation system that is employed worldwide helps to build multidisciplinary projects, and offers the possibility of comparing large amounts of data easily, which should provide enhanced data for bioarchaeology in the future.

Frequency of dental caries in four historical populations from the chalcolithic to the middle ages.

The majority of dental carie studies over the course of historical period underline mainly the prevalence evolution, the role of carbohydrates consumption and the impact of access to dietary resources. The purpose of the present investigation was to compare population samples from two archaeological periods the Chacolithic and Middle Age taking into account the geographical and socio economical situation. The study concerned four archaelogical sites in south west France and population samples an inlander for the Chalcolithic Age, an inlander, an costal and urban for the Middle Age. The materials studied included a total of 127 maxillaries, 103 mandibles and 3316 teeth. Data recorded allowed us to display that the Chalcolithic population sample had the lowest carie percentage and the rural inlander population samples of Middle Age the highest; in all cases molars were teeth most often affected. These ones differences could be explained according to time period, carious lesions were usually less recorded in the Chalcolithic Age than the Middle because of a lesser cultivation of cereals like in les Treilles Chacolithic population sample. In the Middle Age population samples, the rural inland sample Marsan showed the highest frequency of caries and ate more cereal than the coastal Vilarnau and the poor urban St Michel population samples, the first one ate fish and Mediterranean vegetal and fruits and the second one met difficulties to food access, in both cases the consumption of carbohydrates was lesser than Marsan population sample who lived in a geographical land convice to cereals cultivation.

Study of dental caries and periapical lesions in a mediaeval population of the southwest France: differences in visual and radiographic inspections.

Dental caries and periapical lesions have often been studied in archaeological samples. The majority of these studies concern lesions detected clinically and, in some cases, radiography is used to improve the scoring results. The purpose of the present study was to compare and combine the two methods for recording caries and cysts. The studied dental material derived from a mediaeval sample from the south of France. The study included sixty mandibles (788 teeth). Each tooth was observed clinically and radiographically. Absence of teeth was noted and unerupted teeth, which could be viewed on radiographs were also noted. The location and degree of development of each lesion were recorded. Occlusal lesions of degree 1 were mostly detected clinically (5.1% vs.1.4% detected radiographically). Radiographic detection increased the score of approximal lesions of degree 2 (1.4% vs. 0.7%) and the detection of intraosseous lesions. This research has shown that the combination of radiographic and clinical examinations improves the caries detection and thus, increases the caries score in a studied dental sample.

Dental caries, tooth wear and diet in an adult medieval (12th-14th century) population from mediterranean France.

OBJECTIVES: The aims of the present work were to determine the frequency and distribution of caries and tooth wear on paired maxillae of a mediaeval sample from southwest France in which the sex of the remains had been established, and to make a relation with the diet of this population. MATERIALS AND METHODS: The sample analysed consisted of the dental remains of 58 adult individuals (29 men and 29 women) excavated from the mediaeval cemetery of the archaeological site of Vilarnau d'Amont (southwest France). A total of 1395 teeth were examined. RESULTS: The frequency of ante-mortem tooth loss for the sample was 8.7% and the frequency of caries was 17.5%. The frequencies of carious lesions in adult men and women's dentition were 21.9% and 14.0%. The most frequent were occlusal (49.7% and 34.3%) and approximal caries (26.5% and 37.4%). Concerning tooth wear, all 58 individuals were affected by attrition (100%) and more than 90% of the teeth were concerned. Most of them showed the presence of dentin clusters. There was no significant difference between men and women for caries and tooth wear. DISCUSSION: These findings are similar to those of other studies on European populations of the same socio-economic status and confirm the predominance of tooth wear over carious lesions during this period. Both caries and tooth wear may be related to the regional diet of this rural population.

[Study of dental attrition in a medieval adult population from Southwest France]. / Etude de l'attrition dentaire au sein d'une population médiévale adulte du Sud-Ouest de la France.

INTRODUCTION: The aim of the authors was to study dental attrition in a medieval sample of paired mandibles and maxillas from the Southwest France (IX to XV century). MATERIALS AND METHODS: We selected 58 adult individuals with maxillas and mandibles in good state of conservation, 29 women and 29 men from the medieval collection of Vilarnau-d'Amont (Western Pyrenees, France). Attrition was graded according to the Brabant index. RESULTS: We found a high prevalence of attrition in this sample. The first molars (M1) were the maxillary and mandibular teeth most concerned by attrition. The most frequent attrition level was level 2, with dentin exposure. We did not find any significant difference of tooth wear between maxillary and mandibular teeth, even if maxillary teeth seemed to be more worn. There was symmetry of attrition between the left and right side. There was no significant difference between men and women. DISCUSSION: Working on paired mandibles and maxillas showed that attrition in the middle age was a global phenomenon, intermaxillary and symmetric. It was much more severe than today, rapidly evolving and generalized because of the abrasive quality of food, cooking, chewing habits, and intensity of chewing pressure.

[Study of the prevalence and distribution of dental caries in a medieval population in Southwest France]. / Etude de la prévalence et de la distribution carieuse dans une population médiévale du Sud-Ouest de la France.

INTRODUCTION: Teeth are an interesting material for the study of ancient populations. The aim of our study was to determine the prevalence and distribution of caries in a medieval sample of paired maxillas in a rural population in Southwest France and to compare men and women. MATERIALS AND METHODS: Our sample included 58 adults, 29 men and 29 women, with dentate maxillas in good state of conservation, for a total of 1,395 teeth out of a possible 1,846 (75%). The number of caries and their localization were noted. RESULTS: The frequency of antemortem missing teeth was 8.67%. The prevalence of caries was 17.46% and the most frequent caries were occlusal and proximal. Second and third molars were the most frequently affected maxillary and mandibular teeth. Caries on maxillary teeth were statistically more frequent than on mandibular teeth (p<0.05). There was no significant difference between men and women (p>0.05). DISCUSSION: Our study showed that the frequency and the distribution of dental caries in this medieval population from southwest France were comparable to those of other European populations from the same period. The low level of caries was probably due to attrition and noncariogenic food. Differences between men and women were not significant, even though our results suggest that men were much more concerned by caries than women, especially for posterior teeth. A different diet may be the reason for this difference.

Improved oral hygiene and Candida species colonization level in geriatric patients.

OBJECTIVES: This work consists in improving oral hygiene (OH) for elderly dependent people in long-term hospital care, in order to decrease the degree of colonization and the associated risk of developing oral candidiasis. As this population frequently suffers from such colonization and because it is difficult to install and practice OH care, a study protocol was designed at the request of geriatricians. The objective of the present study was to set up a programme of OH, applied by the care staff, and to monitor oral colonization of by Candida spp. BASIC RESEARCH DESIGN: We compared the levels of hygiene and Candida spp. colonization for a group of 110 long-term patients in geriatric departments at T1, when clinical data were collected and oral mycological samples taken before the OH protocol was applied, and at T2, during the postprotocol phase after 3 months of application, when the clinical data and sample collection were repeated. RESULTS: During these 3 months 11 patients died. These patients were excluded from the results, which are presented for matched series of the 99 patients still present at T2. Statistical analysis comparing the clinical and biological parameters at T1 and T2 established that there had been an improvement in OH: the 'adequate' level was reached for 72.4% of patients at T2 compared with 41.8% at T1 (P < 0.001) and the 'very inadequate' level was observed for 9.2% at T2 compared with 27.9% at T1 (P < 0.01). A reduction was observed in the number of patients showing the highest degree of C. albicans and C. glabrata colonization (> 50 colony forming units) from 41.9% at T1 to 24.9% at T2 (P < 0.05) and from 56.4% at T1 to 13.0% at T2 (P < 0.05) respectively. The number of patients with candidiasis fell significantly from 43.2% at T1 to 10.2% at T2. CONCLUSIONS: The OH protocol led to an overall decrease in Candida spp. colonization, a significant reduction in the number of candidiasis and an improvement in the level of oral and denture hygiene but vigilance is still necessary concerning OH care and the initial training of staff in specific care of the mouth.

[Caries free smile: a dental health educational programme]. / "Souris sans carie": une campagne d'éducation bucco-dentaire pluridisciplinaire.

UNLABELLED: A multidisciplinary team associating members from the hospital, national education and local council sectors prepared, and led, a carie-free smile educational campaign in Toulouse. OBJECTIVES: The aim was two-fold: to teach children how to manage their routine oral hygiene while giving a positive image to health care-hence the carie-free smile theme chosen by the team; secondly, to promote an awareness campaign targeting professionals in the education sector (public health sector, independent paediatricians and odontologists) who together constitute the transmitters of our initiative. MATERIAL AND METHODS: The action involved 12,000 children in the 5-8-year age group from 76 public and private schools, 36 kindergarten and primary school leisure centres, six holiday centres together with infant patients from the children's hospital, all of whom were volunteers in the scheme. The team produced back-up material in the form of posters, booklets and stickers; there was also a website dealing with oral hygiene themes, caries and their treatment. Those taking part included practising dentists and students of dentistry. Before the presentation, posters were sent to teachers and other educational partners so as to prepare the children; this included an interactive phase in the presence of the teacher, and a brushing session. Each child was given a booklet, a sticker and a toothbrush. RESULTS: By means of a poll organised among the partners the impact of the campaign could be assessed: firstly, on teachers and children by evaluating their motivation in the setting up of the toothbrushing session in 17 classes following the midday meal, thus appraising their appreciation of the visual material, and secondly, to the dentistry students: the future dentists had noted disparities in oral hygiene practices according to residential area, and thus could appreciate the importance of early provision in the school curriculum, as well as the value of accomplishing this health education task in the daily exercise of their profession.

Salivary defence factor concentrations in relation to oral and general parameters in HIV positive patients.

The objective of this study was to determine the relationships between saliva protein concentrations, oral mucosal lesions, and systemic parameters in HIV positive patients and controls. Twenty-three control volunteers and 58 HIV-antibody positive patients received a complete oral examination and medical evaluation. In saliva and serum samples, protein concentrations were recorded by a nephelometric method. The systemic parameters assessed were CD4+ cell count, CDC stages and antiretroviral therapy. Oral mucosal lesion prevalence was higher among subjects with lower CD4+ counts. Considering the protein profile, correlations were recorded between saliva and serum protein concentration for IgA, haptoglobin and alpha1-proteinase inhibitor. Using assays of immune and non-immune saliva defence factors, we found that the evolution of cellular immuno-suppression during HIV infection was correlated to oral mucosal disease, showing a relationship between local and general systems.

Use of an oral antiseptic bioadhesive tablet in dogs.

V3703 (Stomadhex) is a tablet with bioadhesive properties enabling it to remain in place for several hours after it has been placed on the oral mucosa. It continuously releases chlorhexidine and niacinamide. In a study conducted in 15 dogs, the tablets were well tolerated by the animals. The product significantly reduced (p < 0.05): dental plaque; quantitative periodontopathogen and total anaerobic bacterial counts; spirochetes; and halitosis when used daily over a 14 day period. Gingivitis was also reduced, though not significantly (p = 0.07). Stomadhex treatment can provide a carry-over effect following dental scaling by reducing oral microflora and retarding the reappearance of dental plaque.

[Comparison of protein concentrations in saliva and serum]. / Comparaison des concentrations protéiques de la salive et du sérum.

Saliva and serum protein profiles composed of 12 proteins: IgA, IgG, IgM, albumin, transferrin, alpha 1-glycoprotein acid, alpha 2-macroglobulin, alpha 1-proteinase inhibitor, haptoglobine, C3C, C4 and CRP were obtained by laser nephelometry of aliquots of samples of non-stimulated whole saliva and blood taken at the same time. The population of 138 controls of both sexes was divided into 4 age groups: 1 (20 to 29 years), 2 (30 to 39 years), 3 (40 to 49 years), 4 (50 to 60 years). Using the techniques developed for saliva assay, 10 proteins were measurable: IgA, IgG, IgM, albumin, transferrin, alpha 1-glycoprotein acid, alpha 2-macroglobulin, alpha 1-proteinase inhibitor, haptoglobulin and C3C. The C4 fraction and CRP were present at concentrations lower than the detection limit i.e. at 1.8 and 2.05 mg/l. In the serum 11 proteins were analysed, CRP occurring at less than 0.01 g/l. The statistical two-factor variance analysis test (sex and age) demonstrated the statistically significant influence of age in the saliva for alpha 1-PI and alpha 2-M in the serum for Tf, alpha 2-M and alpha 1-PI, and sex in the serum for IgG, IgM, alpha 1-PI, alpha 2-M and also the interaction of both factors in the serum for alpha 2-M.

[Evaluation of normal protein profile of the mixed saliva and serum by laser nephelometry]. / Evaluation du profil protéique normal de la salive mixte et du serum par néphélémétrie laser.

The aim of this study was to produce a protein profile of both whole saliva saliva and serum in a normal population of adults of both sexes ranging from 18 to 35 years of age using laser nephelometry. Twelve proteins were titrated: IgA, IgG, IgM, C3c, C4, alpha 2-macroglobulin, alpha 1-antitrypsin, C-reactive protein, albumin, hapto-globulin, alpha 1-glycoprotein acid and transferrine. This study is an original attempt to define a normal protein profile in the healthy adult. The next stage will be to analyse the physiopathological variations of this profile in inflammed oral and dental diseases.