Periodontal Care and Treatment Provision by General Dentists in France.

AIM: In many countries, periodontal surgery is mainly provided by periodontists. This specialty is not recognised in France, where periodontal care and treatment are principally the responsibility of general dentists (GDs). The objective of this study was to investigate the periodontal care provided and factors associated with the treatment of periodontal diseases, including periodontal surgery, by GDs in France. METHODS: A national cross-sectional survey of GDs practicing in the French metropolitan area was conducted in 2019. A self-administered questionnaire was sent by mail to the GDs selected by stratified simple random sampling. It included questions on respondents' sociodemographic characteristics and their periodontal practice. A multivariate logistic regression model was employed to identify the factors associated with the practice of periodontal surgery by GDs. RESULTS: Three hundred eighty-five GDs responded (response rate, 23.4%). Their mean age was 45.2 years; 51.2% were male and 83.6% were in private practice. They reported performing selective periodontal examinations such as pocket probing on average for 34.2% of their patients, but only 5.5% of them performed them systematically. Several variables were significantly associated with the provision of periodontal surgical procedures such as the gender of the GDs, full mouth periodontal probing, implantology practice, insufficient fees, or uncertainty about treatment procedure. This survey confirmed the referral of patients for periodontal surgery by a minority of practitioners. It also highlighted insufficient screening and diagnostic procedures for periodontal diseases by GDs. CONCLUSIONS: There is a need to improve French GDs' periodontal skills and knowledge and to address other barriers that currently limit their ability to deliver comprehensive periodontal care.

Delayed diagnosis and inappropriate clinical management of nicorandil-induced oral lesions: A case report.

Oral ulcers have a number of causes, and as a result, their etiology can be difficult to determine. Clinical management can range from simple treatment of the symptoms to extensive surgical excision, as in the case of malignant ulcers. Nicorandil, an antiangina drug, has been identified as a potential trigger for cutaneomucosal ulcers. This article reviews the importance of taking a full medical history when seeking to identify the side effects of treatments. We present the case of a 70-year-old patient with chronic ulceration of the oral mucosa. Determining the cause of ulceration as a side effect of taking nicorandil was delayed because the team that initially managed the patient hypothesized a malignant etiology. As a result, a partial glossectomy was performed for diagnostic and therapeutic purposes. After extensive examination of the patient's medical history and current treatments, nicorandil was identified as the potential trigger. The patient finally recovered after discontinuation of nicorandil.

A 37 mm Spindle Cell Lipoma on the Floor of the Mouth.

Spindle cell lipoma (SCL) is a rare variety of lipoma that mostly arises in male patients and rarely affects the oral cavity. The floor of the mouth is an uncommon site for SCL, and very few cases have been reported in this location. A case of SCL is reported in a 70-year-old woman who had noticed a swelling of the floor of the mouth without any functional consequence. Both ultrasonography and RMI suggested a diagnosis of ranula, whereas clinical palpation showed a nonfluctuant mass. The lesion was excised under local anesthesia. A 37 × 32 mm encapsulated yellow mass was removed. Histological features (mature adipocytes and CD34+ spindle cells) led to a diagnosis of SCL. Medical imaging assessment of this lesion could have been influenced by the high frequency of the ranulas in the floor of the mouth. This case appears to be quite infrequent because of its location (floor of the mouth), its size (over 3.5 cm), and the patient's gender (female).

Fuchs Syndrome: Medical Treatment of 1 Case and Literature Review.

Fuchs syndrome is a particular type of erythema multiforme major; the lesions are only found on the mucosae and specifically affect oral, ocular, and genital mucosae. The cause is not always immediately apparent, which is why this pathology requires a rigorous, detailed clinical examination to eliminate a differential diagnosis. The severity of the symptoms, particularly of oral and ocular symptoms, requires immediate treatment. The treatment of this pathology requires a multiple-drug regime. Through a clinical case study, the objective of this work is to help guide practitioners when diagnosing and treating this pathology as no current consensus exists on these 2 subjects. The authors present the case of a 29-year-old patient who was suffering from a recurring outbreak of Fuchs syndrome, suspected of having been triggered by Mycoplasma pneumoniae. After completing the treatment program based on colchicine and prednisolone, the patient was relieved from pain and has not suffered from any further periodic eruptions of erythema multiforme.

Assessment of leakage at the implant-abutment connection using a new gas flow method.

PURPOSE: The aim of this study was to evaluate, with a new gas flow technique, leakage at the implant/abutment junction in systems with four different connections. MATERIALS AND METHODS: Five Branemark System, five One Morse, five Intra-lock System, and five Ankylos Plus implants and abutments were used. A hole was drilled in the apex of each implant to allow gas to flow through the connection from negative to atmospheric pressure. The gas flow was calculated (slope of pressure decrease, in hPa.s-1). Each connection was tested after both manual and key tightening. Statistical analysis was performed on a generalized linear model with repeated measurements. The significance level was set at α=.05. RESULTS: A global significant difference was observed between the various systems (P=.0001). After manual tightening, gas leakage was (Ln[hPa.s-1], means±standard deviations): One Morse: 0.20 (±1.70); Branemark System: -4.56 (±2.61); Intra-lock: -4.31 (±4.17); Ankylos Plus; -7.59 (±0.76). After key tightening, mean values were: One Morse: -2.51 (±2.72); Branemark System: -7.23 (±1.01); Intra-lock: -7.76 (±0.50); Ankylos Plus; -7.73 (±0.62). CONCLUSION: This study confirms that gas flow is an appropriate method to assess connection leakage. Ankylos Plus connection leakage was very low when the assembly was tightened manually. Among conical connection systems, low (Ankylos Plus) and high (One Morse) leakage was observed. This gas flow study suggests, therefore, that connection design is not the most important parameter for implant/abutment connection leakage.