A national teledentistry study on the knowledge, attitudes, training and practices of private dentists.

Objectives: Nationally examine the self-perceived knowledge, attitudes and practices of TeleDentistry (TD) among dentists in private practice in France. Methods: A descriptive questionnaire-based survey was conducted nationwide from 10 November 2020 to 13 December 2020. The national scale survey was both anonymous and voluntary and was sent by the National Board of Dentists to 42,464 private dentists that were officially registered in France. The questionnaire included 36 questions divided into various sections: (i) general profile (gender, age range, and university, where respondents completed their dental studies), (ii) general knowledge of telemedicine, and (iii) familiarity with current regulations on telemedicine and activities that qualify as telemedicine. Results: Only 57.1% of dentists in private practice stated that they had never heard nor knew about TD (n=2,887). Only 1.5% (n=76) stated they had attended a training module on telemedicine and/or TD during their studies at university. Only 1.3% (n=26) of dentists who practised a TD activity stated that they knew about telemedicine regulations. Only 65.7% (n=2,020) of those who had never practised and 74.8% (n=1,485) who had practised TD acknowledged that they would like to practice TD. Conclusions: In conclusion, this study found a significant need for TD education and training as well as on regulations. It may be necessary in the future to ensure that all stakeholders in the field of dentistry work together to improve these two topics for dental practitioners. It is also worth noting that TD and telemedicine are public health tools and that they could provide inequitable access to medical care. However, TD must be implemented to decrease inequality and ensure it does not do the opposite.

Forensic odontology identification response to terrorist attacks in Paris November 2015.

The terrorist attacks of November 2015 led to the immediate death of 129 victims admitted to the Legal and Forensic Medicine Institute of Paris, including 41 unidentified. During the Disaster Victim Identification (DVI) operations, 22 bodies were examined by the postmortem (PM) dental team with the aim of establishing PM odontograms. At the same time, the dental expert in the antemortem (AM) unit collected a large number of dental files, progressively filtered as the list of missing persons became reduced. Feedback from these events has highlighted the difficulties of implementing the DVI chain principles in a legal framework, published the day before the attacks, and also the technical complexity of collecting dental data on a week end of terror. The return on experience after this event has represented a paradigm shift on previous methods of DVI in Paris and even more in France. Indeed, the victim identification procedure was redesigned, integrating new technical means such as a CT scan directly on spot, allowing the extraction of maxillofacial data as soon as possible in order to support the PM dental examination team. Moreover, the National Dental Council proceeded to the overall remodeling of the dental identification unit, which is composed of trained members, from local, regional and national aspects. These forensic experts are dedicated, at the request of the legal authorities, to DVI operations and deployed throughout the country capable of managing AM and PM data. This unit aims also to share experiences and awareness-raising among health professionals and investigators in order to optimize a better submission of AM elements and also to enhance the major interest of odontology as a primary identifier in disaster.

Elements of morphology: Standard terminology for the teeth and classifying genetic dental disorders.

Dental anomalies occur frequently in a number of genetic disorders and act as major signs in diagnosing these disorders. We present definitions of the most common dental signs and propose a classification usable as a diagnostic tool by dentists, clinical geneticists, and other health care providers. The definitions are part of the series Elements of Morphology and have been established after careful discussions within an international group of experienced dentists and geneticists. The classification system was elaborated in the French collaborative network "TÊTECOU" and the affiliated O-Rares reference/competence centers. The classification includes isolated and syndromic disorders with oral and dental anomalies, to which causative genes and main extraoral signs and symptoms are added. A systematic literature analysis yielded 408 entities of which a causal gene has been identified in 79%. We classified dental disorders in eight groups: dental agenesis, supernumerary teeth, dental size and/or shape, enamel, dentin, dental eruption, periodontal and gingival, and tumor-like anomalies. We aim the classification to act as a shared reference for clinical and epidemiological studies. We welcome critical evaluations of the definitions and classification and will regularly update the classification for newly recognized conditions.

Forensic answers to the 14th of July 2016 terrorist attack in Nice.

The terrorist attack of July 14, 2016 in Nice (France) was a devastating event. A man voluntarily drove a truck into a crowd gathered for the fireworks display on the seaside "Promenade des Anglais," plowing pedestrians down over more than 2 km before being shot dead. At the time of this report, a total of 86 casualties and more than 1200 formal complaints for physical and psychological injuries have been recorded. The aim of this work is to describe the forensic management of this event and its immediate aftermath. This paper reaffirms the basic tenets of disaster management: a single place of work, teamwork in times of crisis, a single communication channel with families and the media, and the validation of the identifications by a multidisciplinary commission. This paper highlights other essential aspects of the organization of the forensic effort put in place after the Nice attack: the contribution of the police at the crime scene, the cooperation between the disaster victim identification (DVI) team, and the forensic pathologists at the morgue, applying the identification (ID) process to unconscious victims in the intensive care unit, the input of volunteers, and the logistics associated with the management of the aftermath of the event. All of the victims were positively identified within 4 and a half days. For the first time in such a paper, the central role of medical students in the immediate aftermath of the disaster is outlined. The need to address the possible psychological trauma of the non-medical and even the medical staff taking part in the forensic effort is also reaffirmed.

Amelogenesis imperfecta: therapeutic strategy from primary to permanent dentition across case reports.

BACKGROUND: Hereditary enamel defect diseases are regrouped under the name "Amelogenesis Imperfecta" (AIH). Both dentitions are affected. Clinical expression is heterogeneous and varies between patients. Mutations responsible for this multigene disease may alter various genes and the inheritance can be either autosomal dominant or recessive, or X-linked. Until now, no therapeutic consensus has emerged for this rare disease. CASE PRESENTATION: The purpose of this article was to report treatments of AIH patients from childhood to early adulthood. Treatment of three patients of 3, 8 16 years old are described. Each therapeutic option was discussed according to patients' age and type of enamel alteration. Paediatric crowns and resin based bonding must be preferred in primary teeth. In permanent teeth, non-invasive or minimally invasive dentistry should be the first choice in order to follow a therapeutic gradient from the less invasive options to prosthodontic treatments. CONCLUSION: Functional and aesthetic issues require patients to be treated; this clinical care should be provided as early as possible to enable a harmonious growth of the maxillofacial complex and to prevent pain.

Only four genes (EDA1, EDAR, EDARADD, and WNT10A) account for 90% of hypohidrotic/anhidrotic ectodermal dysplasia cases.

Hypohidrotic and anhidrotic ectodermal dysplasia (HED/EDA) is a rare genodermatosis characterized by abnormal development of sweat glands, teeth, and hair. Three disease-causing genes have been hitherto identified, namely, (1) EDA1 accounting for X-linked forms, (2) EDAR, and (3) EDARADD, causing both autosomal dominant and recessive forms. Recently, WNT10A gene was identified as responsible for various autosomal recessive forms of ectodermal dysplasias, including onycho-odonto-dermal dysplasia (OODD) and Schöpf-Schulz-Passarge syndrome. We systematically studied EDA1, EDAR, EDARADD, and WNT10A genes in a large cohort of 65 unrelated patients, of which 61 presented with HED/EDA. A total of 50 mutations (including 32 novel mutations) accounted for 60/65 cases in our series. These four genes accounted for 92% (56/61 patients) of HED/EDA cases: (1) the EDA1 gene was the most common disease-causing gene (58% of cases), (2)WNT10A and EDAR were each responsible for 16% of cases. Moreover, a novel disease locus for dominant HED/EDA mapped to chromosome 14q12-q13.1. Although no clinical differences between patients carrying EDA1, EDAR, or EDARADD mutations could be identified, patients harboring WNT10A mutations displayed distinctive clinical features (marked dental phenotype, no facial dysmorphism), helping to decide which gene should be first investigated in HED/EDA.

Efficacy of topical 1% lidocaine in the symptomatic treatment of pain associated with oral mucosal trauma or minor oral aphthous ulcer: a randomized, double-blind, placebo-controlled, parallel-group, single-dose study.

AIMS: To determine the efficacy in pain reduction of a topical 1% lidocaine compared to a placebo cream in patients with oral mucosal lesions due to trauma or minor oral aphthous ulcer. METHODS: The design was a double-blind, randomized, placebo-controlled, six-center trial on 59 patients. Pain intensity and relief were measured using a 100-mm visual analog scale (VAS). One-tailed Student t test and ANOVA analyses were used for statistical analyses. RESULTS: Independent of the pain origin (oral mucosal trauma or minor oral aphthous ulcer), the application of the 1% lidocaine cream led to a mean reduction in VAS pain intensity of 29.4 mm ± 17.0, which was significantly greater than the decrease obtained with the placebo cream. Analysis showed a statistically significant efficacy of the 1% lidocaine cream (P = .0003). Its efficacy was not related to the type of lesion, and no adverse drug reaction, either local or systemic, was reported by any of the patients. CONCLUSION: A significant reduction in pain intensity occurred after application of 1% lidocaine cream and was significantly greater than that with the placebo cream. Taking into account the study's limitations, this product seems safe to use.