[Diabetes mellitus and early failures in oral implantology]. / Diabète et échecs précoces en implantologie orale.

It has become increasingly common for diabetic patients to be considered as candidates for dental implants. However even though success rates of implant therapy in diabetic are high, this does not preclude failures. Failure to osseointegrate in the initial healing phase results in a fibrous tissue encapsulation of the implant and clinical mobility, leading ultimately to the failure of the implant. This review presents the current knowledge regarding the effect of diabetes mellitus on the osseointegration of implants including pathophysiologic aspects as well as their potential implications on bone metabolism and osseointegration, implant success rate at the second-phase surgery and guidelines for pre and post-operative management. In experimental models of diabetes mellitus, a reduced level of bone-implant contact has been shown, and this can be reversed by means of treatment with insulin. Compared with the general population, a higher failure rate is seen in diabetic patients. Most of these occur at the second-phase surgery, seemingly pointing to the microvascular complications of this condition as a possible causal factor. It is necessary to take certain special considerations into account for the placement of implants in diabetic patient. A good control of plasma glycemia, together with other measures, has been shown to improve the percentages of implant survival in these patients.

[Clinical and therapeutic aspects of trigeminal neuralgia. Apropos of 27 cases treated at the General Hospital of Grand-Yoffin Dakar]. / Aspects cliniques et thérapeutiques de la névralgie faciale essentielle du trijumeau. A propos de 27 cas colligés a l'Hôpital Général de Grand-Yoff de Dakar.

The trigeminal neuralgia or "painful tic" of the face is an invalidating affection, which affects the quality of life of the patient. The odontologist must be able to diagnose it and take part in his good therapeutic assumption of responsibility. The diagnosis is sometimes difficult, being able to involve unsuited therapeutic methods prejudicial for the patient. The objective of our study was to analyse the clinical and therapeutic aspects of the trigeminal neuralgia. It was a transverse and descriptive study which 27 files of patients suffering of trigeminal neuralgia and treated in the odontology service of the General hospital of Grand-Yoff in Dakar between July 2002 and July 2008. We exploited the following parameters: the age, the sex, the oral state, duration of the symptoms, characteristics of the pain, the type of treatment. 22 patients of the 27 cases were female. The time of consultation was often late, the patients generally preferring begin with the traditional treatments. The neuralgia of V2 dominated the clinical picture, followed that neuralgia of V3. The pain was strictly unilateral, it was started by movement, speaking, eating or touching the trigger zone. The prescription of carbamazepine (Tegretol) was systematic, and constituted a true test diagnosis, it made possible to obtain an immediate sedation of the pains. In front of the medicamentous treatment failure, the alcoholization of the trigeminal branch has given good performances, indeed it made possible to obtain, a clear lull of more than 12 months for 9 patients out of the 10 who profited from it. The alcoholization of the trigeminal nerve remains an effective cure and constitutes an accessible alternative under our work conditions in Africa.

[Should the administration of anticoagulants be altered for oral surgery: a study of 32 cases]. / Faut-il interrompre l'administration d'anticoagulants pour un Acte de Chirurgie Buccale: a propos d'une étude de 32 cas.

INTRODUCTION: The study is transversal and descriptive. It take place in the odontology department in a public hospital in Dakar (Senegal), during 09 month (January-September 2005). The objective of this work was to determine the TP-INR value making possible to carry out an act of oral surgery without haemorrhagic risk. (INR = International Normalized Ratio). MATERIAL AND METHOD: It concerned 32 patients referred to the Odontology service by the Cardiology They presented a cardiovascular pathology having required an anticoagulant therapy, and also need an act of oral surgery. We exploited the following parameters: identification of the patient, oral state, types of oral surgery, types of cardiopathy, AVK posology, value of TP-INR, haemostatics means. RESULTS: 81.25% of the patients were women (26), with a sex ratio of 0.23. The mean age was 53ans, with 21 and 84 years like the extremes. 56.25% of our patients had undergone a single extraction, 25% had beneficed multiple extractions, and 18.75% had profited from a scaling-curetting. The average value of the TP-INR was 2.22 with extremes between 2 and 2.84. CONCLUSION: In favour of the haemostat means, no haemorrhagic complication post operational was revealed. It is allowed that the risk of thromboembolic accident by stopping the treatment is much more prejudicial than the hemorrhagic risk for the patient.

[Treatment of dental trauma injuries in a public health department]. / Prise en charge des traumatismes dentaires dans un service public de sante au Senegal.

INTRODUCTION: The aim of this study is to show that the socioeconomic situation in Africa influences the treatment of dental trauma. MATERIALS AND METHOD: This retrospective study on the treatment of dental trauma was carried out in the department of stomatology in the Universitary Teaching Hospital Aristide Le Dantec (HALD). It concerned 568 patient's records on an 11-year-period, with 1759 teeth. RESULTS: The therapeutic attitude consisted almost exclusively in avulsion of traumatised primary teeth (95.9%), and privileged conservative treatment of traumatised permanent teeth (67.8%), while taking in consideration the socio-economic conditions responsible of delayed consultation, few treatment options and difficult follow up. CONCLUSION: The systematic avulsion of the traumatised primary teeth is justified and the conservative treatment of the traumatised permanent teeth must always be tried in first intention.

[Clinical study of cysts jawbones]. / Etude clinique des kystes maxillaires.

The objective of this study was to appreciate the clinical and paraclinical aspects of cysts jawbones. It was an exploratory study about 61 cases of jawbones cysts (24 men and 37 women). It took place in the Odontostomatology Department of the General Hospital of Grand Yoff at Dakar, during a period of 5 years (February 1996 to December 2000). The mean age of patients was 29.67 years with extremes of 14 and 55 years. The mean reason of consultating was an important perish-jawbone tumefaction which can be associated with dental displacements, mobilities or pains. The radiographic assessment was essential for the diagnosis. The radiological image was characterized by an osteolysis with regular contours. We have noted the invasive appearance of the osseous lysis which is developed in several teeth concerning 50 cases (81.97%). The anatomo-pathological exam which is essential to confirm the diagnosis has been possible only for 9 patients by lack of means. Thus, in our study the diagnosis of jawbones cyst was retained while being based primarily on clinical experience and the radiological assesment. The types of diagnosed cysts are: 53 perish-apical cysts (86.89%), 5 dentigerous cysts (08.20%), 2 globulo-jawbone cycts (03.28%), and only one case of paramount cyst. The jawbones cysts are often of aggressive development with various etiologies. They may be voluminous. Their diagnosis must be exact in order to allow an adapted surgical technics and to prevent the reccurence.

[Surgical and orthodontic treatment of inclusions and dental retentions: report on the upper incisives and canines block]. / Traitement chirurgico-orthodontique des inclusions et rétentions dentaires: à propos du bloc incisivo-canin supérieur.

We have consecrated this retrospective report to the clinical study and treatment of 18 cases of inclusions and dental retention observed in the services of orthodontics and oral surgery of the department of odontology of the medical faculty of the Dakar University. From that study it arises that 50% of the inclusions and retentions are casually discovered and that canines and central incisives take up to the first place. With regard to the surgical treatment associated to orthodontics, it is only seldom worked up because of its duration and the late appearance of the results. However it agrees to retain that the treatment of these affections can be conceived only in the point of view of a multidisciplinary approach.

[Clinical study of alveolites and their treatment in multiple practice]. / Etude clinique des alveolites et leur prise en charge en omnipratique.

The alvéolite is an post-extractionnel accident, very frequent, unforeseeable, characterized by a deterioration of the physiological process of formation of the clot and occurring as well at the healthy subject at the degenerate. The objective of this work is to make an exploratory study on the cases of alvéolites which have occurred in three structures of odontological care in Dakar between October 2000 and June 2001. We studied the clinical and therapeutic aspects alveolites among 55 patients having undergone 168 extractions. On the whole 68 cases of alveolites were indexed including 18 suppurées forms and 50 dry forms. The alveolite was occured among 44 women and 11 men and the section of age which most touched ranges between 20 and 29 ans (51 %). The evoked factors etiologic are multiples(taken oral contraceptives, use of vasoconstricteurs. technical of extraction etc?). The treatment is local by type of antiseptic paste and general with base of antibiotic, antiseptic and anti-inflammatory. We don't have real coding of the treatment. The prevention remains the best attitude and consists with: - To carry out the acte operational with a rigorous asepsis - To avoid the inopportune instrumental traumatisms - To Irrigate the bone in permnance during the utilisation of rotary instruments.

[Maxillary fissure cysts in Senegal. Analysis of a series of 14 cases]. / Les kystes fissuraires des maxillaires au Sénégal. Analyse d'une série de 14 cas.

The fissurary cyst is an non-odontogene and epithelial cyst. Their frequency in Senegal compared to the epidemiological records in European countries had led the authors to carry out a study. Around 14 fissurary cysts have been recorded in a seven year period. The teeth affected by the tumour could be saved in case of an early diagnosis.

[Benign maxillary tumors. Epulis in Senegal]. / Les tumeurs bénignes des maxillaires. Les épulis au Sénégal.

The epulis is a hyperplasic tumour restricted to the gum. It is the most widely spread tumour among the benin gum tumours. It has various etiologies. The authors emphasize the epidemiological and clinical aspects of 96 cases. Four types of epulis are observed, the most common type being the acquired epulis. On an etiological level, the factor related to oral hygiene is the most criticized. Their frequency in the oral pathology should lead the dental surgeon to master his treatment.

[The position of the nasopalatine and anterior palatine nerve foramina]. / Etude de la position des points d'émergence des nerfs nasopalatin et palatin antérieur.

The study of the position of palatine anterior and posterior foramen with regard to some anatomic landmarks easily identified has to improve the local technical anesthesia for the palatal vault. In that manner, through a study carried on 98 skulls, we defined using five parameters, the situation of the emergence points of the vault palatal nerves; these landmarks give to clinician greater technical assurance.

Anesthesie tronculaire du nerf dentaire inferieur : position de l'epine de Spix sur une population de type negro-africain

Apres avoir defini des parametres chiffres en fonction des reperes anatomiques classiques; les auteurs decrivent la position de l'epine de Spix dans une population de type negro-africain. Les differentes formes de l'epine de Spix rencontrees dans cette population ont egalement ete etudiees et comparees a celles decrites chez d'autres populations

[HIV infection: a new concern in dental public health]. / L'infection à VIH: nouvelle préoccupation en santé publique dentaire.

The authors report the results of a seroepidemiological study, conducted in Senegal on dental personnel. This study allows them to confirm that professional dental practice is a factor of risk for the HIV infection. This study recommends work methods to the dental profession.

PIP: During January-March 1990, at 26 of 38 dental facilities throughout Senegal, health workers took blood samples from 10 dental surgeons, 60 nurse specialists in dentistry, and 21 dental health agents so researchers could determine the prevalence of HIV infection among dental public health providers. There were 2.67 men for every woman. Women were more likely to be dental surgeons than men. Most subjects were 26-35 years old and worked in the Dakar region. Five persons (3.81%) were infected with HIV. Three had HIV-1 infection (2.29%), one had HIV-2 infection (0.76%), and one had dual infection (HIV-1 and HIV-2) (0.76%). All three HIV-1 infection cases were women as well as dental surgeons. The remaining cases were men as well as nurse specialists in dentistry. The age of all HIV infected persons but one fell between 25 and 35. The age of the other case fell within the 36-45 age group. Four of the HIV infected persons were married and monogamous. The remaining case was single. All HIV positive persons had been practicing their profession for at least four years. The sole HIV-2 positive person had been practicing his profession for 10 years. Since there is the case of an HIV positive dentist in Florida (USA) who had transmitted HIV to five patients, one should not rule out the possibility of HIV transmission from dental professionals to patients. Thus, dental professionals should use bleaching solution diluted to 10% for 10 minutes. This solution should be available for all dental services. Dental providers should wear gloves, masks, and goggles with all patients. They should use single-use sterile material for each patient. Adequate emergency measures to prevent nosocomial transmission of HIV must be established in Senegal.

L'anesthesie locale au trou mentonnier (position du foramen mentonnier chez les sujets de type senegalais: application pratique)

L'anesthesie au trou mentonnier permet le blocage du rameau terminal du nerf dentaire inferieur; ce qui en fait une technique courante dans la pratique quotidienne

Techniques de reconstitution labiale dans les sequelles de noma

Le noma; encore trop frequent dans les pays developpes; provoque des pertes de substance toujours difficile a corriger. Nous decrivons notre technique de reconstitution labiale par un lambeau d'avancement labial total

[Pterygo-cavernous thrombophlebitis and temporo-mandibular ankylosis in dental infections]. / Thrombophlébite ptérygo-caverneuse et ankylose temporo-mandibulaire au décours d'une infection dentaire.

The authors report the complications of a case of cellulitis from dental origin. A cavernous sinus thrombophlebitis and a temporo-mandibular ankylosis succeed, pointing on the importance of a precocious treatment of dental phlegmons, in order to prevent occurrence of local or regional complications.

[Antibiotic sensitivity of germs isolated from cellulitis of dental origin in Senegal (results of a survey of 49 cases)]. / Sensibilité aux antibiotiques des germes isolés dans les cellulites d'origine dentaire au Sénégal (résultats d'une enquête sur 49 cas).

Irregular results sometimes found during antibiotic treatment of perimaxillar cellulitis, conducted the authors to study bacteriology of these infections from dental origin. This study confirmed the aero and anerobic polymicrobism of these cellulitis. Antibiograms realised in 49 cases showed occurrence of streptococcal and anaerobic germs resistance to antibiotics usually prescribed. A nearly constant success of other antibiotics allowed the authors to define a first intention antibiotherapy for the treatment of these infections.