Prevalence of periodontal disease in young Moroccans: A national survey.

BACKGROUND: There are few large surveys of periodontal disease in young age cohorts, and national surveys in Africa do not exist. This study assessed the prevalence and severity of periodontal disease in a national survey of adolescents and young adults in Morocco. METHODS: A multistage probability sampling design was used to draw a sample of 14,667 students 12-25 years old attending 87 schools. The sample was representative of approximately three million Moroccan students in this age group. RESULTS: A total of 27.9%, 11.9%, and 7.7% of the subjects had ≥1 tooth with ≥4, ≥5, and ≥6 mm probing depth, and the population estimates were ≈ 822,436, 349,961, and 226,297 affected subjects, respectively. For attachment loss, the prevalences were: 11.6%, 9.5%, and 6.9% (or ≈ 341,761, 281,043, and 203,977 affected subjects) for ≥4, ≥5, and ≥6 mm, respectively. The rates of probing depth and attachment loss increased significantly with the increase in age (p < 0.01, p < 0.001). Sex and urban status did not show significant effects on the prevalence of periodontal disease (p > 0.05). Similarly, the relationship between the occupation status and periodontal status was modest and not statistically significant (p > 0.05). CONCLUSIONS: Children and young adults attending public schools in Morocco have a high prevalence and severity of periodontal disease compared with other populations of similar age. The rate of periodontal disease reported here may be used as baseline population estimates in the surveillance of disease status in this population.

National survey of periodontal diseases in adolescents and young adults in Morocco.

AIM: National surveys of periodontal diseases in children are rare. This study describes the first national survey of oral health of adolescents attending public schools in Morocco. We report the prevalence and demographic determinants of periodontal diseases, and generate population estimates for this young population. MATERIALS AND METHODS: This study used a multi-stage probability sample comprising 14,667 students in 87 schools and 520 classrooms, representative of students attending grades 6-12 (age 12-18 years) in Morocco. The students were interviewed and then examined clinically to assess their periodontal status, which was classified according to the 2017 World Workshop. In addition, the diagnosis of aggressive periodontitis (AgP) was assessed. RESULTS: Of approximately 3 million students in this age cohort, 12.3% (or approximately 360,894 subjects) had periodontitis and 46.9% (1.4 million) had gingivitis. They comprised 10.8%, 2.9%, and 6.1% subjects with periodontitis stage I, II, and III/IV, respectively; 5.0%, or 148,336 subjects, had AgP. The prevalence rates were not significantly different by gender or urban status. However, the prevalence of AgP was particularly high in certain regions of Morocco. CONCLUSIONS: The prevalence of staged periodontitis and AgP in this young population is among the highest reported in national surveys worldwide.

Regenerative Treatment of Peri-Implantitis: A Systematic Revie.

Objectives: The aim of this systematic review was to assess the clinical efficacy of bone regeneration for treatment of peri-implantitis. Materials and Methods: Electronic search of the literature was performed to identify randomized clinical trials (RCTs) and case series on treatment of peri-implantitis using bone regeneration procedures with at least 6 months of follow-up. The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) were applied. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Results: Two RCTs and 16 case series with a total of 520 treated patients (2002 implants) were included. Bone regenerative procedures showed controversial results regarding bone fill. Two studies reported statistically significant bone gain while four studies reported insignificant bone gain. Other studies reported bone gain with no P value. Pocket depth (PD) reduction varied among the studies since four studies reported a significant reduction in PD while four others reported insignificant reduction in PD. Other studies reported a reduction in PD with no P value. Bone regeneration procedures seemed to decrease bleeding on probing (BOP) but they did not seem conducive to increase the width of keratinized gingiva. Increased keratinized gingiva was noted in cases with subepithelial grafts. Conclusion: Evaluation of the effectiveness of bone regeneration techniques in this systematic review presented limitations related to heterogeneity in patient selection (age, history of periodontitis, smoking status and implant system), means of disinfection and decontamination, and variability of the materials used for treatment.

Effect of Bone Regeneration with Mineralized Plasmatic Matrix for Implant Placement in Aesthetic Zone.

Bone volume is one of the key factors to be considered when evaluating implant placement. When the bone volume is insufficient, implant placement could be conditioned by the necessity of preforming bone grafting procedures to compensate bone loss. Various grafting procedures can be used with different bone substitute. Mineralized Plasmatic Matrix (MPM) is one of these grafting materials, used to maintain or regenerate the socket's volume. In MPM, the autologous blood products highly concentrated in platelets and fibrin in a liquid state are combined with a bone substitute. The fibrin can become bound to bone particles. The filling material is easy to shape and a PRF-type membrane is also generated. In the present case we report the application of MPM in two sites presenting bone crest defects when placing implant in those areas.

Aggressive and chronic periodontitis in a population of Moroccan school students.

AIM: This study assessed the prevalence, clinical characteristics, and demographics of chronic and aggressive periodontitis in a representative sample drawn from a subpopulation in Morocco. MATERIALS & METHODS: Eight hundred and thirty students representative of 12+ years old attending schools in the Province of Benslimane, Morocco were selected by a multi-phased, probability sampling. Their age was 12-25 years (mean: 16.1 years) and comprised of 50% males and 50% females. Chronic and aggressive periodontitis were determined clinically. RESULTS: A total of 31% and 10.1% of the subjects had ≥4 mm and ≥6 mm attachment loss, respectively; 4.9% had aggressive periodontitis, and 6.4% had chronic periodontitis. Subjects with chronic periodontitis typically had 4-5 mm attachment loss affecting a few molars or premolars. Subjects with aggressive periodontitis had ≥5 mm attachment loss affecting multiple teeth, and 68% and 73% of these subjects had ≥6 mm attachment loss affecting maxillary and mandibular molars respectively. Attachment loss and periodontitis were significantly more prevalent in the 19-25 years group, than the 12-18 years age group. There were no significant differences in disease prevalence by gender or ethnic groups (Arab versus Berber). CONCLUSION: This young Moroccan population is at high risk of destructive periodontal disease, and further studies are indicated to investigate the biological and environmental factors that may contribute to the increased risk of disease in this population.

Molecular Dynamics Approach in the Comparison of Wild-Type and Mutant Paraoxonase-1 Apoenzyme Form.

There is some evidence linking the mammalian paraoxonase-1 (PON1) loops (L1 and L2) to an increased flexibility and reactivity of its active site with potential substrates. The aim of this work is to study the structural, dynamical, and functional effects of the most flexible regions close to the active site and to determine the impact of mutations on the protein. For both models, wild-type (PON1wild) and PON1 mutant (PON1mut) models, the L1 loop and Q/R and L/M mutations were constructed using MODELLER software. Molecular dynamics simulations of 20 ns at 300 K on fully modeled PON1wild and PON1mut apoenzyme have been done. Detailed analyses of the root-mean-square deviation and fluctuations, H-bonding pattern, and torsion angles have been performed. The PON1wild results were then compared with those obtained for the PON1mut. Our results show that the active site in the wild-type structure is characterized by two distinct movements of opened and closed conformations of the L1 and L2 loops. The alternating and repetitive movement of loops at specific times is consistent with the presence of 11 defined hydrogen bonds. In the PON1mut, these open-closed movements are therefore totally influenced and repressed by the Q/R and L/M mutations. In fact, these mutations seem to impact the PON1mut active site by directly reducing the catalytic core flexibility, while maintaining a significant mobility of the switch regions delineated by the loops surrounding the active site. The impact of the studied mutations on structure and dynamics proprieties of the protein may subsequently contribute to the loss of both flexibility and activity of the PON1 enzyme.

[Paraoxonase-1 (PON1) activity in patients with coronary artery diseases and in diabetic patients].

Cardiovascular diseases are the main cause of mortality in the world, diabetics and patients with coronary artery diseases in particular. In fact, the increase of cardiovascular risk was established in many epidemiological and clinical studies. The aim of this work is to study both the lipid profile and the enzymatic activity of PON1 in diabetics and coronary patients from Morocco (Casablanca region) along with the cardiovascular risk factors in this population. Three groups of Moroccan subjects were investigated: 36 patients with coronary artery diseases, 110 diabetic patients and 100 healthy subjects (control group). Total cholesterol (TC), triglycerides (TG) and high-density lipoprotein cholesterol (c-HDL) levels were evaluated using colorimetric methods. Low-density lipoprotein cholesterol (c-LDL) was calculated according to the Friedewald's formula. Serum activity of PON1 was measured by spectrophotometry. Compared to healthy subjects, we noted a significant decrease of PON1 activity in coronary artery disease (285 U/mL ±â€Š180 U/mL; P < 0.05) and in diabetic (167 U/mL ±â€Š71 U/mL; P < 0.05) patients. In addition, we found that diabetic patients recorded significantly elevated LDL, TG and TC levels. In parallel, coronary artery disease patients scored TG level. The present study revealed an abnormal lipoprotein profile associated with hypertriglyceridemia, low levels of c-HDL, high levels of c-LDL and significant decrease of PON1 activity. These findings confirm the high risk of cardiovascular diseases in diabetic and coronary artery disease patients.