The Added Value of a Collagenated Thermosensitive Bone Substitute as a Scaffold for Bone Regeneration.

A pre-hydrated thermosensitive collagenated biomaterial which sets at body temperature and maintains the space of the missing alveolar bone volume, OsteoBiol GTO® (GTO), has been released as a bone substitute. This study was designed to check its angiogenic and osteogenic potentials compared to OsteoBiol Gen-Os® (Gen-Os) and Geistlich Bio-Oss® (Bio-Oss). Samples of materials were incubated in culture media to obtain the extracts. Collagen release was measured in the extracts, which were used to investigate human periodontal ligament (hPDL) cell proliferation (MTT), colonization (Scratch assays) and growth factor release (ELISA). The effects on endothelial cell proliferation (MTT) and organization (Matrigel® assays) were also studied. Finally, endothelial and mesenchymal Stem Cell (hMSC) recruitment (Boyden Chambers) were investigated, and hMSC Alkaline Phosphatase (ALP) activity was measured. A higher collagen concentration was found in GTO extract, which led to significantly higher hPDL cell proliferation/colonization. All materials increased VEGF/FGF-2 growth factor secretion, endothelial cell recruitment, proliferation, and organization, but the increase was highest with GTO. All materials increased hMSC recruitment and ALP activity. However, the increase was highest with collagenated GTO and Gen-Os, which enhanced C5a and BMP-2 secretion. Overall, GTO has higher angiogenic/osteogenic potentials than the collagenated Gen-Os and the anorganic Bio-Oss. It provides a suitable scaffold for endothelial and mesenchymal stem cell recruitment, which represent essential bone regeneration requirements.

Oral cancer: Current status and public health perspectives / Le cancer oral : état des lieux et perspectives de santé publique

Despite advances in surgical and oncological treatments, the incidence and five-year survival rates (~50 percent) of oral cancers (OC) have not improved over the last decades and remain a major public health problem. Seventy percent are still diagnosed at a late stage (T3 or T4), with an average delay in diagnosis of two to five months. As the cure and survival of patients are directly related to the development stage of the tumor at the time of diagnosis, the objective of this work was to analyze all the determinants related to oral cancer and to propose new clinical approaches for diagnosis and screening. A proposal for new models of screening, training, and concrete action to improve public awareness of the major global problem of OC is made. The strengths and weaknesses of OC screening studies need to be objectively understood to effectively guide and energize testing in primary care settings, with the prospect of using new and emerging technologies that can help improve the discriminatory accuracy of case detection. Most national organizations have not, to date, recommended population-based mass screening, due to a lack of sufficient scientific evidence of associated mortality reduction. Where health care resources are high, opportunistic individual screening is recommended, although the low diagnostic capacity of front-line clinicians is alarming.

Malgré les progrès des traitements chirurgicaux et oncologiques, les taux d'incidence et de survie à 5 ans (~50 %) liés aux cancers oraux (CO) ne se sont pas améliorés au cours des dernières décennies et demeurent un problème majeur de santé publique. 70 % sont encore diagnostiqués à un stade tardif (T3 ou T4), avec un délai de diagnostic moyen de 2 à 5 mois. La guérison et la survie des patients étant directement liées au stade de développement de la tumeur au moment du diagnostic, l'objectif de ce travail est d'analyser l'ensemble des déterminants liés au cancer oral et de proposer de nouvelles approches cliniques de diagnostic et de dépistage. De nouveaux modèles de dépistage, de formations et d'actions concrètes sont proposés pour mieux sensibiliser la population à la problématique mondiale majeure que constitue le CO. Les forces et faiblesses des études de dépistage du CO nécessitent d'être objectivement appréhendées, pour orienter efficacement les essais dans les établissements de soins primaires et les dynamiser, avec la perspective d'utiliser de nouvelles technologies émergentes qui peuvent aider à améliorer la précision discriminatoire de la détection des cas. La plupart des organisations nationales n'ont, jusqu'à présent, pas recommandé le dépistage massif de la population, en raison d'un manque de preuves scientifiques suffisantes quant à la réduction de la mortalité qui lui serait associée. Lorsque les ressources en soins de santé sont élevées, un dépistage individuel opportuniste est recommandé, bien que la faiblesse de la capacité diagnostique des cliniciens en première ligne soit alarmante.

Impacted second molars, which surgical treatment choosing? / Absence d'évolution des deuxièmes molaires, quel traitement chirurgical proposer ?

Introduction: Delayed evolution of second molars is a rare phenomenon with an estimated prevalence in the mandible of 0 to 2.3%. Many etiologies have been proposed to explain these inclusions, among which the reduction of arch perimeter, distalization of first molar, mesio-angulated position of the second molar. However, the presence and position of the third molar does not seem to be a risk factor for this inclusion. Materials and Methods: Several therapeutics options with surgical management have been proposed in the literature; surgical repositioning, surgical release of the crown more or less associated with orthodontic treatment, and sometimes avulsion of the second molar to allow the third molar development. There is no recommendation on this subject, the literature describing mostly retrospective studies and case reports. Conclusion: This article presents the different therapeutic options in the treatment of second molar inclusions.

Introduction: Les retards d'évolution des deuxièmes molaires sont des phénomènes rares avec une prévalence estimée à la mandibule de 0 à 2,3 %. De nombreuses étiologies ont été proposées pour expliquer ces inclusions, parmi lesquelles la réduction du périmètre d'arcade, la distalisation des premières molaires, la position mésio-angulée de la seconde molaire. En revanche, la présence et la position de la troisième molaire ne semblent pas être un facteur de risque de cette inclusion. Matériels et méthodes: Plusieurs options thérapeutiques associant une prise en charge chirurgicale ont été proposées dans la littérature. Il s'agit du repositionnement chirurgical, du dégagement chirurgical de la couronne plus ou moins associé à un traitement d'orthodontie et parfois de l'avulsion de la deuxième molaire pour laisser évoluer la troisième molaire. Il n'existe pas de recommandation sur ce sujet, la littérature décrivant le plus souvent des études rétrospectives et des cas rapportés. Conclusion: Cet article présente les différentes options thérapeutiques dans le traitement des inclusions des secondes molaires.

Relationship between internet research data of oral neoplasms and public health programs in the European Union.

BACKGROUND: Tobacco and alcohol are the main risk factors for oral squamous cell carcinoma, the low survival rate of which is a public health problem. European-wide health policies (a prevention campaign, tobacco packaging) have been put in place to inform the population of the risks associated with consumption. Due to the increase in smoking among women, the incidence of this disease remains high. The identification of internet research data on the population could help to measure the impact of and better position these preventive measures. The objective was to analyze a potential temporal association between public health programs and interest in oral cancers on the internet in the European Union (EU). METHODS: A search of data from Google ©, Wikipedia © and Twitter © users in 28 European countries relating to oral cancer between 2004 and 2019 was completed. Bibliometric analysis of press and scientific articles over the same period was also performed. The association between these data and the introduction of public health programs in Europe was studied. RESULTS: There was a temporal association between changes in tobacco packaging and a significant increase in internet searches for oral cancer in seven countries. Unlike national policies and ad campaigns, the European awareness program Make Sense has had no influence on internet research. There was an asymmetric correlation in internet searches between publications on oral cancer from scientific articles or "traditional" media (weak association) and those from internet media such as Twitter © or Wikipedia © (strong association). CONCLUSION: Our work highlights seven areas around which oral cancer awareness in Europe could be refocused, such as a change in the communication of health warnings on cigarette packs, the establishment of a more explicit campaign name regarding oral cancer, the involvement of public figures and associations in initiatives to be organized at the local level and the strengthening of awareness of the dangers of tobacco in the development of oral cancer.

Development of an Artificial Intelligence Model to Identify a Dental Implant from a Radiograph.

PURPOSE: The objective of this study was to develop a deep convolutional neural network (CNN) that would identify the brand and model of a dental implant from a radiograph. MATERIALS AND METHODS: A data augmentation procedure provided a total of 1,206 dental implant radiographic images of three different brands for six models (Nobel Biocare NobelActive [NNA] and Br.nemark System [NBS], Straumann Bone Level [SBL] and Tissue Level [STL], and Zimmer Biomet Dental Tapered Screw-Vent [ZTSV] and SwissPlus [ZSP]). They were divided into a test group (n = 241; 19.9%) and a training and validation group (n = 965; 80%). Preprocessing and transfer learning were applied to a pretrained GoogLeNet Inception CNN network. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value, receiver operating characteristic (ROC) curve, and area under the ROC curve (AUC) of the CNN model were evaluated. RESULTS: The diagnostic accuracy was 93.8% (95% CI: 87.2% to 99.4%), the sensitivity was 93.5% (95% CI: 84.2% to 99.3%), the specificity was 94.2% (95% CI: 83.5% to 99.4%), the positive predictive value was 92% (95% CI: 83.9% to 97.2%), and the negative predictive value was 91.5% (95% CI: 80.2% to 97.1%). The deep CNN algorithm achieved an AUC of 0.918 (95% CI: 0.826 to 0.973) on NNA, 0.922 (95% CI: 0.831 to 0.964) on NBS, 0.909 (95% CI: 0.844 to 0.982) on SBL, 0.890 (95% CI: 0.783 to 0.945) on STL, 0.931 (95% CI: 0.867 to 0.979) on ZTSV, and 0.911 (95% CI: 0.811 to 0.957) on ZSP. CONCLUSION: The deep CNN model had a very good performance in identifying a dental implant from a radiograph. A huge and varied database of radiographs would have to be built up to be able to identify any dental implant.

Peri-implantitis risk factors: A prospective evaluation.

AIM: The aim of the present study was to create a tool to evaluate the risk of peri-implantitis according its severity. METHODS: After ethics committee approval, 43 patients provided signed consent and were included prospectively. Forty-five observations were recorded. The following criteria were recorded: number of implant faces showing bleeding and/or suppuration, pocket depth on at least two faces of the implant, bone loss as a function of the length of the implant evaluated on X-rays, number of implant faces with bacterial plaque, the parameters required for determination of excess cement (screwed or sealed prosthesis, burying of sealed prostheses), periodontal status, glycemia, and annual consumption of tobacco. Each of these parameters was plotted on a chart using Microsoft Excel. RESULTS: Seventeen of 45 (37.8%) cases were identified as having high peri-implantitis risk, two of 45 (4.4%) had low risk, and 11 of 45 (24.4%) had moderate risk; 33.3% patients did not have peri-implantitis and were considered at very low risk. CONCLUSION: The observed results applied to the evaluation model are an effective diagnostic tool in assessing the risk of peri-implantitis. The tool takes into account parameters, which have not been taken into account until now. The information is automatically processed and allows early management of peri-implantitis.

Sodium Hypochlorite Accident: A Systematic Review.

INTRODUCTION: Sodium hypochlorite (NaOCl) extrusion beyond the apex, also known as "a hypochlorite accident," is a well-known complication that seldom occurs during root canal therapy. These "accidents" have been the subject of several case reports published over the years. Until now, no publication has addressed the global synthesis of the general and clinical data related to NaOCl extrusion. The main purpose of this article was to conduct a systematic review of previously published case reports to identify, synthesize, and present a critical analysis of the available data. A second purpose was to propose a standardized presentation of reporting data concerning NaOCl extrusions to refine and develop guidelines that should be used in further case report series. METHODS: A review of clinical cases reporting NaOCl accidents was conducted in June 2016 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist; it combined an electronic search of the PubMed database and an extensive manual search. RESULTS: Forty full-text articles corresponding to 52 case reports published between 1974 and 2015 were selected. Four main categories of data were highlighted: general and clinical information, clinical signs and symptoms of NaOCl extrusions, management of NaOCl extrusions, and healing and prognosis. Overall, up to now, clinical cases were reported in a very unsystematic manner, and some relevant information was missing. CONCLUSIONS: A better understanding of the potential causes, management, and prognosis of NaOCl accidents requires a standardization of reported data; this study proposes a template that can fulfill this objective.

Gender Determination of Adult Individuals by Three-Dimensional Modeling of Canines.

Gender determination is a fundamental issue in forensic anthropology. Many techniques based on bone and dental remains have been proposed. It is not always possible to implement the techniques using bones, but teeth are often perfectly preserved. It has been demonstrated that the canine has the greatest sexual dimorphism, and the aim of this work was to provide an easy and accurate dental technique for determining the gender in the absence of other skeletal elements. The sample was composed of 210 CT scans with four healthy canines. The 840 canines were modeled using MIMICS® 10.01 software. The total volume of each tooth was determined. Seven mathematical models were determined by binary logistic regressions and ranked in order of relative performance. The seven proposed predictive models thus performed (0.910≤AUC≤0.938), with overall rates of correct predictions between 82.38 and 85.24%. The 4-canine model is the most powerful for predicting the gender.

Implications of endodontic-related sinus aspergillosis in a patient treated by infliximab: a case report.

INTRODUCTION: Sinus aspergillosis is a potential complication after root canal therapy of antral teeth. Indeed, zinc oxide-eugenol cement overfilling in the sinus may promote fungal infection. Moreover, if sinus aspergillosis triggers chronic sinusitis with aspergilloma, it may also lead to invasive phenomena, especially for immunocompromised patients. METHODS: We reported a sinus aspergillosis case of a patient treated with infliximab (Remicade; Janssen Biologics BV, Leiden, Netherlands). The purpose of this article was to explore the mechanisms of this pathosis, especially the impact of the root canal sealer overextension, which is a contributing factor for fungal infection. The surgical management and the follow-up are also described. RESULTS: Six months after surgery, the patient showed no clinical signs and presented with a healthy and airy right maxillary sinus on the computed tomography scan. CONCLUSIONS: In conclusion, prevention and screening of aspergillosis of maxillary sinus may be considered before starting an anti-tumor necrosis factor alpha therapy.

Age determination of adult individuals by three-dimensional modelling of canines.

Accurate age determination is fundamental in both forensic medicine and anthropology. Many methods that relate dental characteristics to adult age have been proposed, but there is still no simple and reliable method that does not damage the study material. The aim of this work was to propose a relevant and practical technique for determining age in adults that could be used in both living and deceased individuals. The sample was composed of 210 CT scans from individuals aged from 15 to 85 years old, with four healthy canines present in the mouth. The 840 canines were modelled using Mimics® 10.01 software. The pulp volume/total volume ratio ×100 was determined for each tooth. Seven mathematical models, corresponding to all possible real situations, were determined by the weighted least squares method and ranked in order of relative performance. The adequacy of the seven models to the data was very high with the regressions proposed (0.915 < R (2) adjusted < 0.964). Ranked in order of performance, the maxillary model was the most powerful of the seven models for age determination, followed by the 4 canines model, the 13 model and the 23 model.