Facteurs déterminants la prévalence de la carie dentaire chez les patients consultant au service d'odontologie du centre hospitalier régional de Tenkodogo, Burkina Faso

La carie dentaire est une maladie universelle répandue à travers le monde depuis des millénaires. C'est une maladie multifactorielle non transmissible évitable. Afin de réduire son impact, la présente étude a eu pour objectif de rechercher les facteurs déterminant la prévalence de la carie dentaire au service d'odontologie du Centre Hospitalier Régional (CHR) de Tenkodogo au Burkina Faso. Méthodologie. Il s'est agi d'une étude transversale descriptive qui s'est déroulée du 11 mars au 11 avril 2015. Un guide d'entretien individuel adressé aux patients a servi à la collecte des données. Le profil socio-économique, le niveau de connaissance sur l'hygiène bucco-dentaire, les pratiques en matière d'hygiène buccale, le mode alimentaire et le niveau de connaissance sur la carie dentaire ont été les variables recueillies. Résultats. Cent quarante patients dont 62,1 % de sexe féminin ont participé à l'étude. L'âge moyen était de 33,1 ans. La prévalence carieuse était de 97,1 % avec un indice DCAO moyen de 3,68 %. Un tiers des patients avait un niveau de connaissance suffisant sur l'hygiène buccale. La consommation quotidienne d'aliments sucrés était retrouvée chez 69,3 % et la pratique du grignotage chez 62,1%. La douleur était le motif de première consultation (57,1%). La visite préventive au cabinet dentaire était méconnue par 93,6 % des patients. Conclusion. Les résultats ont montré une insuffisance de connaissance de la maladie carieuse. Seule la sensibilisation pourrait aider à la réduction de la prévalence de la carie au sein de la communauté

Evaluation of the mono instrument (Wave One) mechanical action on the bacterial load reduction: In vitro study of 32 permanent human teeth.

CONTEXT: Enterococcus faecalis is the most common bacteria found in infected root canals. AIM: The purpose of this study was to evaluate the effect of the mono instrument (wave-one®) on the reduction of E. faecalis in root canals. MATERIALS AND METHODS: Thirty-two human monoroot teeth were used. After sterilization by autoclave, the teeth were infected by E. faecalis and incubated for 24 h. Each tooth underwent sampling before and after the root canal shaping. After serial dilution, samples were incubated, and colony-forming units were counted. RESULTS: The mono instrument technique reduced infection by E. faecalis in root canals of 30 teeth. The mean bacterial load (log10) was 3.98 before treatment and 1.20 after treatment. The paired t-test showed a significant mean difference (log10) of the bacterial load before and after treatment (P < 0.0001). CONCLUSION: This study found that the mono instrument (Wave One®) significantly decreases bacterial load in root canals. However, the instrument alone is not enough to eradicate infections; thus, the use of a complementary antimicrobial is required.

Bonding effectiveness of self-etch adhesives to dentin after 24 h water storage.

PURPOSE: This study evaluated the immediate bonding effectiveness of five self-etch adhesive systems bonded to dentin. MATERIALS AND METHODS: The microtensile bond strength of five self-etch adhesives systems, including one two-step and four one-step self-etch adhesives to dentin, was measured. Human third molars had their superficial dentin surface exposed, after which a standardized smear layer was produced using a medium-grit diamond bur. The selected adhesives were applied according to their respective manufacturer's instructions for µTBS measurement after storage in water at 37°C for 24 h. RESULTS: The µTBS varied from 11.1 to 44.3 MPa; the highest bond strength was obtained with the two-step self-etch adhesive Clearfil SE Bond and the lowest with the one-step self-etch adhesive Adper Prompt L-Pop. Pretesting failures mainly occurring during sectioning with the slow-speed diamond saw were observed only with the one-step self-etch adhesive Adper Prompt L-Pop (4 out of 18). CONCLUSIONS: When bonded to dentin, the self-etch adhesives with simplified application procedures (one-step self-etch adhesives) still underperform as compared to the two-step self-etch adhesive Clearfil SE Bond.

Randomized Clinical Trial of Intraosseous Methylprednisolone Injection for Acute Pulpitis Pain.

INTRODUCTION: The present study reports the results of a randomized clinical trial comparing local intraosseous methylprednisolone injection and emergency pulpotomy in the management of acute pulpitis on efficacy, safety, and efficiency end points. METHODS: After providing prior informed written consent, 94 patients consulting for acute irreversible pulpitis pain at university-affiliated teaching hospital dental clinics in Dakar, Senegal were randomly assigned to either the methylprednisolone treatment group (n = 47) or the pulpotomy treatment group (n = 47). Patients were followed up at 1 week and assessed 6 months later to evaluate the therapeutic outcome of their treatment. RESULTS: At day 7 the patients in the methylprednisolone group reported less intense spontaneous and percussion pain in the day 0-day 7 period than the patients in the pulpotomy group. Methylprednisolone treatment took approximately 7 minutes (4.6-9.3) less to accomplish than pulpotomy (or about half the time). No difference in the therapeutic outcome was found between the 2 treatment groups at 6 months (all credible intervals span 0). CONCLUSIONS: This study establishes that methylprednisolone injection for acute pulpitis is relieved by a minimally invasive pharmacologic approach more effectively than by the reference pulpotomy and conserves scarce dental resources (ie, endodontic equipment and supplies, dental surgeon's time).

Root canal shaping by single-file systems and rotary instruments: a laboratory study.

INTRODUCTION: The aim of this study was to compare the shaping ability of two single-file systems and conventional rotary instruments in severely curved root canals of extracted human molars. METHODS AND MATERIALS: Mesiobuccal canals of 120 mandibular molars with angles of curvature ranging between 25(°) and 35(°) and radii of curvature from 5 to 9 mm, were divided into three groups (n=40). In each group the canals were instrumented with either WaveOne (W), Reciproc (R) or ProTaper (P). The time required for canal shaping and the frequency of broken instruments were recorded. The standardized pre and post-instrumentation radiographs were taken to determine changes in working length (WL) and straightening of canal curvature. The presence of blockage or perforation was also evaluated. Data were analyzed using the one-way analysis of variance (ANOVA) and post-hoc Tukey's test. The level of significance was set at 0.05. RESULTS: Both single-instrument systems reduced the canal preparation time by approximately 50% (P<0.05). No incidence of broken instruments from single-file systems was reported; however, two F2 instruments in the P group were broken (P<0.05). Reduction in WL and straightening of canal curvature was observed in all three systems with the highest scores belonging to P system (P<0.05). No case of blockage or perforation was found during shaping in any group. CONCLUSION: Single-file systems shaped curved canals with substantial saving in time and a significant decrease in incidence of instrument separation, change in WL, and straightening of canal curvature.

One-year clinical evaluation of the bonding effectiveness of a one-step, self-etch adhesive in noncarious cervical lesion therapy.

This study evaluated the one-year clinical performance of a one-step, self-etch adhesive (Optibond All-in-One, Kerr, CA, USA) combined with a composite (Herculite XRV Ultra, Kerr Hawe, CA, USA) to restore NCCLs with or without prior acid etching. Restorations performed by the same practitioner were evaluated at baseline and after 3, 6, and 12 months using modified USPHS criteria. At 6 months, the recall rate was 100%. The retention rate was 84.2% for restorations with prior acid etching, but statistically significant differences were observed between baseline and 6 months. Without acid etching, the retention rate was 77%, and no statistically significant difference was noted between 3 and 6 months. Marginal integrity (93.7% with and 87.7% without acid etching) and discoloration (95.3% with and 92.9% without acid etching) were scored as Alpha or Bravo, with better results after acid etching. After one year, the recall rate was 58.06%. Loss of pulp vitality, postoperative sensitivity, or secondary caries were not observed. After one year retention rate was of 90.6% and 76.9% with and without acid conditioning. Optibond All-in-One performs at a satisfactory clinical performance level for restoration of NCCLs after 12 months especially after acid etching.

Knowledge of and management attitude regarding dentin hypersensitivity among dentists from a West African country.

AIM: The aim of the present study was to assess knowledge of, and management attitude of dentists regarding dentin hypersensitivity. MATERIALS AND METHODS: The study involved all the dentists from private and public sectors, exerting in Senegal. The following data were requested from the surveyed dentists using an anonymous questionnaire; sociodemographics (i.e. age, gender, area of activity, etc.) and knowledge on triggering factor, type of pain, diagnosis, preventive and curative procedures. RESULTS: Out of the 238 dentists who received the questionnaire, 68.9% returned properly filled forms. They were 116 males and 48 females with a mean age of 41.99 ± 8.50 years. Eighty three percent of the participants had a good understanding of the characteristics of pain related to DH and 92% recognized chemical and thermal stimuli as triggering factor while mechanical stimulus was not evoked. Many responders (90.9%) did not have any idea of the mechanism for pain transmission across the dentin. Regarding diagnosis technique, 68% use mechanical stimuli to elicit DH pain. Regarding management procedure, the use of desensitizing tooth paste is the mostly chosen option followed by professional topical application of fluoride. More than 1/3rd of the surveyed dentists confess resorting to root canal to manage DH. CONCLUSION: We recommend incorporation of basic science knowledge on orofacial pain and competencies to manage painful conditions like dentin hypersensitivity. Also, health regulatory institutions should make continuing dental education a requirement to preserve the dental licensure.