Relationship between periodontal diseases and newly-diagnosed metabolic syndrome components in a sub-Saharan population: a cross sectional study.

BACKGROUND: Oral health is a frequently ignored aspect of global health in sub-Saharan patients. Periodontitis, a very frequent oral disease has been proven to be associated to development of the metabolic syndrome. This study aims to evaluate the relationship between periodontal disease and metabolic syndrome components in a sub-Saharan population. METHODS: We performed a cross sectional study in 3 Yaounde hospitals. Consenting adults aged 21 years and above were recruited. Participants who presented with a tooth loss of at least 50% or any condition which could alter values of biological and periodontal parameters (tobacco smoking, pregnancy, chronic kidney disease, cancer) were excluded. Metabolic syndrome elements (glycaemia, arterial pressure, HDL cholesterol, abdominal circumference, triglycerides) and periodontal variables were recorded (plaque and gingival index of Silness and Loe, periodontal pocket depth and clinical attachment loss). These variables were compared using Fisher's exact Test and odds ratio calculated with 95% confidence intervals. RESULTS: The prevalence of periodontitis and metabolic syndrome were 43.4% and 10.8% respectively. Age (37.75 ± 13.25, P < 0.001) and poor accessory brushing methods were associated risk factors for development of periodontal disease. Sub-Saharan sindividuals with periodontitis had increased odds of having obesity (OR 11.1 [95% CI 3.97-31.03], P < 0.001) and low HDL (OR 4.58 [95% CI 1.79-11.70], P = 0.001) CONCLUSION: Our findings suggest an association between periodontal disease and metabolic syndrome in Sub-Saharan subjects. Increasing age and poor accessory brushing methods are associated risk indicators.

Secondary mandibular osteomyelitis complicated with a pathological fracture.

INTRODUCTION AND IMPORTANCE: Pathological mandibular fractures, defined as fractures that occur in regions where bone has been weakened by an underlying pathological process, are rare, accounting for fewer than 2 % of all fractures of the mandible. Mandibular pathological fractures can have several aetiologies including osteomyelitis, osteoradionecrosis (ORN), surgical interventions, bisphosphonate-related osteochemonecrosis of the jaw and tumoral lesions. CASE PRESENTATION: We present a case of a 13-year-old male patient following a tooth infection with a right facial swelling and limited mouth opening, multiple purulent cutaneous fistulas and mandibular hypoplasia. Intraoral examination revealed the presence of generalized calculus, dental mobility in quadrants 3 and 4. We carried out an orthopantomography which revealed a mandibular angle fracture and the diagnosis of secondary mandibular osteomyelitis with pathological fracture was retained. Sequestrectomy was carried out followed by an open reduction with mini reconstruction plates. CLINICAL DISCUSSION: At 13 years old, this patient with a secondary mandibular osteomyelitis, to the best of our knowledge is the youngest case reported having a secondary mandibular osteomyelitis as etiology of his pathological fracture. Due to the early onset, the patient presented with a bird's profile clinically. His pathological fracture was due to a vicious cycle limiting bone turnover created by the secondary osteomyelitis. CONCLUSION: Pathological mandibular fractures are complex and challenging to treat because of their different aetiologies and also clinicians often have to deal with individuals with grossly infected bone with the fracture management dependent on the resulting bony defect.