A radiographic study of the mandibular third molar root development in different ethnic groups.

BACKGROUND: The nature of differences in the timing of tooth formation between ethnic groups is important when estimating age. AIM: To calculate age of transition of the mandibular third (M3) molar tooth stages from archived dental radiographs from sub-Saharan Africa, Malaysia, Japan and two groups from London UK (Whites and Bangladeshi). MATERIALS AND METHODS: The number of radiographs was 4555 (2028 males, 2527 females) with an age range 10-25 years. The left M3 was staged into Moorrees stages. A probit model was fitted to calculate mean ages for transitions between stages for males and females and each ethnic group separately. The estimated age distributions given each M3 stage was calculated. To assess differences in timing of M3 between ethnic groups, three models were proposed: a separate model for each ethnic group, a joint model and a third model combining some aspects across groups. The best model fit was tested using Bayesian and Akaikes information criteria (BIC and AIC) and log likelihood ratio test. RESULTS: Differences in mean ages of M3 root stages were found between ethnic groups, however all groups showed large standard deviation values. The AIC and log likelihood ratio test indicated that a separate model for each ethnic group was best. Small differences were also noted between timing of M3 between males and females, with the exception of the Malaysian group. These findings suggests that features of a reference data set (wide age range and uniform age distribution) and a Bayesian statistical approach are more important than population specific convenience samples to estimate age of an individual using M3. CONCLUSION: Some group differences were evident in M3 timing, however, this has some impact on the confidence interval of estimated age in females and little impact in males because of the large variation in age.

[Two clinical examples of the use of orthodontic mini-screws]. / Deux exemples cliniques de l'utilisation des mini-vis orthodontiques.

Orthodontic needs to reply on a reliable anchoring as fixed as possible to ensure the best orthodontic movements. The orthodontic mini-screws provide a fixed anchorage for performing movements and treatments considered until then to be difficult or even impossible, particularly the treatment of ingression in the posterior area. The orthodontic anchorage mini-screw has the advantage of being cheaper, easier to place and do not require surgical procedure. This article illustrates two clinical indications of orthodontic mini-screws namely the intrusion of incisors and cross tooth movement.

Adaptation and validation of the Moroccan Arabic version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ).

OBJECTIVE: The aims of this study were to translate and culturally adapt the PIDAQ native English version into Moroccan Arabic, and to assess the psychometric characteristics of the version thereby obtained. MATERIALS AND METHODS: The PIDAQ original English version was sequentially subjected to translation into Moroccan Arabic, back-translation into English, committee review, and pre-testing in 30 subjects seeking orthodontic treatment. RESULTS: The final Moroccan Arabic version further underwent an analysis of psychometric properties on a random sample of 99 adult subjects (84 females and 15 males, aged 20.97 ± 1.10 years). The intraclass coefficient correlation of the scores of the responses obtained after administration of the questionnaire twice at a 1-month interval to a random sample of 30 subjects ranged from 0.63 for "Self-confidence" to 0.85 for "Social Impact". Cronbach α coefficients ranging from 0.78 for "Aesthetic Concerns" to 0.87 for "Self-confidence" were obtained; the different subscales of the Moroccan Arabic version of the PIDAQ showed good correlation with the perception of aesthetics and orthodontic treatment need. CONCLUSION: The results of the present study indicate that the Moroccan Arabic version of the PIDAQ obtained following thorough adaptation of the native form is both reliable and valid. It is able to capture self-perception of orthodontic aesthetic and treatment need and is consistent with normative need for orthodontic treatment.

[Relationship between the obstructive character of the tonsils and the sagittal cephalometric measurements]. / Relations entre le caractère obstructif des amygdales palatines et les mensurations céphalométriques du sens sagittal.

INTRODUCTION: The role of obstructive tonsils in the sagittal dimension of the skeleton-dental abnormalities is widely discussed in the literature but remains controversial. Data on the probable relationship between obstructive tonsils and the presence of these abnormalities were subjective. The objective of this study was to quantify the relationship between the obstructive character of the tonsils and the sagittal cephalometric measurements. MATERIALS AND METHODS: A cross-sectional study was performed in children aged between 6 to 12 years divided into 2 groups (A and B) according to the obstructive character of the tonsils. Cephalometric measurements were recorded on each child. Data were analyzed using SPSS 20.0 for Windows. At Student test was used to compare quantitative variables according to the obstructive character of the tonsils. Significance was set at p = 0.05. RESULTS: Subjects with obstructive tonsils (group B) are significantly more trend to have a convex facial profile and a skeletal class II with more mandibular retrusion and retroclined incisor compared with subjects without obstructive tonsils (group A). CONCLUSION: Early evaluation of children with obstructive tonsils can prevent sagittal dimension of the squeleto-dental abnormalities caused by upper airway obstruction. Thus late and more aggressive treatments which are not always as efficient as when they were performed during childhood will be avoided.

[Sagittal photogrammetric evaluation of the soft tissue profile between two different racial groups: a comparative study]. / Caractéristiques photogrammétriques sagittales de profil des tissus mous chez deux groupes raciaux. Etude comparative.

INTRODUCTION: Facial soft-tissue analyses made from photographic records (photogrammetric analysis of the soft tissues) showed interracial dimorphism. Standard of these facial analyses, originally obtained from Caucasian might not be appropriate for the diagnosis and treatment planning of other groups of orthodontic patients. The purpose of this study was to compare the sagittal photogrammetric soft tissue profile characteristics between Senegalese and Moroccan adults. MATERIALS AND METHODS: A cross-sectional study was performed in a group of Senegalese and Moroccan students in the Faculty of Medicine, Pharmacy and Dentistry of Dakar. Standardized facial-profile photographs were taken with each student in natural head position, centric relation, and relaxed lip posture. Twenty four linear parameters were measured on paper sheet using a graduated ruler. For each variable mean and SD were calculated. In addition independent samples t-test was performed to detect sexual and racial dimorphism. Results were regarded as significant at p = 0.05. RESULTS: Senegalese subjects had significantly more lips protrusion than Moroccan who had significantly a more elongated and more anterior positioned nose, a more chin prominence and a tendency to cutaneous class II than Senegalese. CONCLUSION: Further studies including different age groups subjects would allow having longitudinal data according to age.

[Relationship between bizygomatic width and the size of maxillary anterior teeth among young Senegalese black people recruited in army]. / Corrélation entre la distance bizygomatique et la largeur des dents antéromaxillaires chez les jeunes sénégalais mélanodermes recrutés dans le service militaire.

INTRODUCTION: Prosthetic teeth size and placement must be in perfect harmony with the bucco-facial structures for a successful and esthetic removable prosthesis. This study aimed to determine among young Senegalese black people facial index estimating maxillary central incisor width and distance between canine points starting from bizygomatic width. PATIENTS AND METHODS: 621 black Senegalese participated to this transversal study. Measurements were made using anthropometric slide caliper and electronic slide caliper. The comparative analysis was carried out by the test t of Student. The correlative analysis used the chi-square test. The risk of error was fixed at 5%. RESULTS: Positive correlations were found between variables. Distance between canine points was significantly (p = 0.000) correlated to bizygomatic width and central incisor width. Using bizygomatic width, the average dividing factors to estimate central incisor width and distance between canine points were respectively 15.13 and 3.75. CONCLUSION: Distance between canine points and central incisor width can be given starting from bizygomatic width, as guide of selecting maxillary anterior prosthetic teeth width.

A study of cephalometric soft tissue profile among adolescents from the three West African countries of Nigeria, Ghana and Senegal.

BACKGROUND: Since the introduction of cephalometry, numerous studies have established normal values for Caucasian populations. In Africa, most investigations have established norms and ethnic variations associated with the skeletal pattern. To date, there has been no study comparing soft tissue patterns among adolescents in the West African sub-region. OBJECTIVES: The objective of this investigation was to determine and compare soft tissue patterns among 12- to 16-year-old Nigerian, Ghanaian and Senegalese adolescents, establish any gender dimorphism and compare them with published Caucasian norms. METHODOLOGY: Lateral cephalometric radiographs of adolescents with a normal incisor relationship aged between 12 and 16 years from Nigeria, Ghana, and Senegal were taken under standardized conditions and traced to determine soft tissue patterns. Data obtained were subjected to statistical analysis. RESULTS: The total sample consisted of 165 females and 135 males with a mean age of 13·96 (1·58) years. A number of soft tissue parameters showed significant differences (P<0·05). These included comparison between males and females, and Nigerian, Ghanaian and Senegalese, including lip separation, upper lip length, upper lip exposure, Li-esthetic line, lower lip-NP, nasal tip angle, N-Pr-Pg, Pg-Ls, B-N pogonion and pogonion-mandibular angle. Differences also existed between these West African soft tissue values and published Caucasian norms, including nasolabial angle, mentolabial angle, nasal depth, nose tip, total soft tissue facial convexity and nasal depth angle. CONCLUSIONS: The comparative analysis of soft tissue patterns among 12- to 16-year-old adolescents from Nigeria, Ghana and Senegal demonstrated statistically significant differences in soft tissue value between these West African adolescents and published Caucasian soft tissue norms. This study provides useful data in relation to soft tissue parameters for subjects originating from the West African sub-region.

[Correlations between colorimetric parameters of teeth, eyes and skin. Perspectives in the choice of tooth shade for complete denture]. / Correlations entre les parametres colorimétriques des dents, des yeux et de la peau. Perspectives dans le choix de la teinte des dents en prothèse adjointe complète.

Rehabilitation with complete denture include among other objectives, improvement of facial and dental esthetics. To these ends, the artificial teeth should mimic as far as possible, healthy and natural dentition. The main objective of this study was to investigate factors associated with tooth color among black African subjects. One hundred and two subjects (72 men and 30 women) were included in this investigation. The colorimetric parameters of their teeth as well as those of the conjunctiva of their eyes and skin were recorded from standardized photographs. Two software, Mesurim and Photoshop were used for that purpose. Univariate and linear regression analysis were run to assess the association between tooth color and the variables age, gender and colorimetric parameters of eyes and skin. It appears from the result of this study that tooth color was positively and significantly associated with age. Stepwise multiple regression analysis further revealed that tooth hue can be best predicted by a combination of skin complexion and brightness and eye lightness.

[Relationships between the dental arches measurements and the peak nasal inspiratory flow (PNIF): a cross sectional study on 78 Senegalese teenagers]. / Relations entre les mensurations des arcades dentaires et le débit nasal inspiratoire de pointe: etude transversale sur 78 adolescents Senegalais.

INTRODUCTION: Upper airways obstruction can result in the reduction of the transversal dimensions of the maxillary arch which affect the vertical and the sagittal dimensions. The PNIF measure is an objec- tive and cheap way to assess the upper airways permeability. The aim of this study was to determine the relationship between PNIF and dental arch sizes. MATERIALS AND METHODS: Seventy eight patients (40 girls and 38 boys) age ranged 10-15 years were included in this cross sectional study. The PNIF was measured with a Youlten peak flow meter (Clement Clarke International, London, United Kingdom). The sagittal, vertical and transversal dimensions of the dental arches were evaluated on dental casts with a digital caliper (Mitutoyo Corporation, Tokyo, Japan). T test was used to assess differences in PNIF and dental arches variables between subjects grouped according to sex (male and female). The Pearson's correlation coefficient was used to analyze the relationship between the dental arches sizes and the PNIF. The significance was set at p < 0.05. RESULTS: PNIF rate was higher in girls than in boys but the difference was not significant. There were sexual dimorphism regarding the anterior and total lengths of the upper arch, the total length of the lower arch and the maxillary intermolar width which are significantly more important for boys (p respectively equal to 0.05; 0.03; 0.04 and 0.04). The PNIF was significantly and negatively correlated with the total length of the upper arch (r = -0.25). The others measurements did not show significant correlation with PNIF. CONCLUSION: Others parameters are needed to complement the peak nasal inspiratory flow rate for the respiratory disorders related dental arches sizes abnormalities diagnosis.

Apical root resorption in patients wearing orthodontic appliances.

The aim of our study was to evaluate the incidence of orthodontically induced root resorption during the tooth alignment and leveling phase, and to assess the impact of the variables age, sex and degree and direction of incisor displacement. We studied a consulting population at the dentofacial orthopaedics unit of the Dental Consultation and Treatment Centre (DCTC), Casablanca. Our sample was composed of 30 exposed cases and 30 non-exposed cases, followed up for a period of 8 months. A survey document was drawn up for data collection, and retro-alveolar radiographic imaging was used to evaluate resorption. Our results showed that the patients receiving orthodontic treatment all developed minor root resorptions during the alignment and levelling phase in the incisor group. We found that the central incisors underwent greater resorption than the lateral incisors.

[Passive correction of an anterior open bite related to non-nutritive sucking habits: report of a case]. / Correction passive de l'infraclusion antérieure associée une Habitude de Succion Non-Alimentaire (HSNA): rapport de cas.

The term anterior open bite refers to a vertical space between the upper and lower front teeth in maximum intercuspation. This malocclusal trait can accompany many malocclusions of the Angle's classification. Two types of anterior open bite have been described: skeletal and dental open bite. The latter may have Non Nutritive Sucking Habits (NNSH) as causal factor and is deemed to aggravate without treatment. This article presents an interceptive approach based on the use of a fixed passive appliance interfering with sucking habit. It consists of a crib soldered to bands adjusted to the maxillary first permanent or temporary second molars. The device was globally well accepted by the patient and has been effective in breaking the sucking habit and subsequently in closing the bite after only 5 month. When psychological approach is not effective, a fixed deterrent device may be recommended for weaning children off nonnutritive sucking habits.

[Cephalometric features of patients referred for orthodontic treatment at the Dentistry Department of Dakar University]. / Caractéristiques céphalométriques de sujets reçus en consultation d'orthodontie à la clinique du Département d'odontologie de Dakar.

INTRODUCTION: Each ethnic group has its own characteristics. The aim of this study was to determine the morphological characteristics of a Senegalese population. MATERIALS AND METHODS: Sixty two lateral cephalograms of Senegalese patients were assessed in a cross sectional study. All lateral cephalometric films were traced on a transparent cellulose acetate sheet by the same operator. Conventional cephalomebic analysis was performed with 17 measurements (6 linear and 11 angular) t test was used to assess differences in age and cephalometric variable between subjects grouped according to sex (male and female). A P value of < or = 0.05 was considered statistically significant. RESULTS: No statistically significant differences were found between Senegalese men and women. This study shows an increase in the maxillary protrusion and a decrease in the mandibular protrusion with his corollary of skeletal class II. The mean of the vertical dimension measurements suggest a hyperdivergence. Protrusive lips were associated with incisors protrusion. CONCLUSION: These results which show morphological differences between Senegalese subjects and other populations consolidate the idea that the racial and ethnic characteristics must be taken into account during orthodontic diagnosis and treatment planning.

[Relationships between masticatory performance and nutritional state in complete denture wearers]. / Relations entre Performance Masticatrice et Etat Nutritionnel chez des Sujets Porteurs de Prothèses Complètes.

UNLABELLED: For many authors masticatory dysfunctions are related to reduction in dietary intake with malnutrition as a possible consequence. The aim of the present study was to further investigate the relationships between masticatory performance and nutritional state in complete denture wearers. METHOD: Masticatory performance was assessed using a granulometric method in 74 subjects divided into 2 subgroups according to their dental status (normal dentition and complete dental wearers). Nutritional status of study subjects was analyzed with Mini Nutritional Assessment (MNA). RESULTS: There were a significant association between wearing denture and Nutritional Status as assessed by MNA. Using this scale, a risk of malnutrition was found in 80% of subjects wearing complete denture and in 26% in the normal dentition sub group (p < 0.0001). There were also a positive and significant correlation between, the particle size distribution and masticated test food and nutritional status. CONCLUSION: Complete denture wearers are at greater risk of malnutrition than did subjects with normal dentition.

Inequalities in access to education and healthcare.

The burden of disease is borne by those who suffer as patients but also by society at large, including health service providers. That burden is felt most severely in parts of the world where there is no infrastructure, or foreseeable prospects of any, to change the status quo without external support. Poverty, disease and inequality pervade all the activities of daily living in low-income regions and are inextricably linked. External interventions may not be the most appropriate way to impact on this positively in all circumstances, but targeted programmes to build social capital, within and by countries, are more likely to be sustainable. By these means, basic oral healthcare, underpinned by the primary healthcare approach, can be delivered to more equitably address needs and demands. Education is fundamental to building knowledge-based economies but is often lacking in such regions even at primary and secondary level. Provision of private education at tertiary level may also introduce its own inequities. Access to distance learning and community-based practice opens opportunities and is more likely to encourage graduates to work in similar areas. Recruitment of faculty from minority groups provides role models for students from similar backgrounds but all faculty staff must be involved in supporting and mentoring students from marginalized groups to ensure their retention. The developed world has to act responsibly in two crucial areas: first, not to exacerbate the shortage of skilled educators and healthcare workers in emerging economies by recruiting their staff; second, they must offer educational opportunities at an economic rate. Governments need to lead on developing initiatives to attract, support and retain a competent workforce.

[Study of mastication in denture wearers among various ages]. / Etude des parametres physiologiques de la mastication chez des sujets ages porteurs de protheses adjointes completes.

INTRODUCTION: Recent studies have shown that it was possible for subjects with masticatory deficiency chewing achieve a satisfactory level of fragmentation of food by acting on some physiological parameters as the number of cycles and the time devoted to a sequence of mastication. METHOD: The objective of this work is to study the effects of the wearing of complete prostheses, of ageing on the physiological parameters from the chewing on a population of 110 subjects. RESULTS: The results show an important effect of the dental status. Indeed denture weaers need twice more cycles than controls of the same age to make a ham portion ready to be swallowed. Significant an age effect with regard to the number of cycles was also noted. The rheology of food affects the number of cycles which increases with the hardness of food.

[Influence of orthodontic anomalies on periodontal condition]. / Influence des anomalies orthodontiques sur l'état parodontal.

INTRODUCTION: Three main reasons are routinely cited to justify the provision of orthodontic treatment: improvement of facial and dental aesthetics and of dental health and function. However, association between malocclusions and periodontal condition is still controversial. The aim of the present study was to further investigate the correlation between certain orthodontic anomalies and periodontal condition. MATERIALS AND METHOD: One hundred and one subjects were included in this study. Information regarding oral hygiene habits and accessibility to professional oral health care were obtained from each subject. Malocclusions were assessed with the Indice of Orthodontc Treatment Need (IOTN) and the Index of Complexity, Outcome and Need (ICON) and periodontal with the Community Periodontal Index for Treatment Need (CPITN). Spearman Rank correlation order was used to test for any association between malocclusions and periodontal condition. Significance was set at the 5% level. RESULTS: Contact point displacements (malpositions) are positively and significantly correlated to CPITN in the mandibular arch. There was also significant negative correlation between spacing and CPITN in the maxilla. Openbite and overjet assessed by IOTN have a significant positive correlation with the periodontal condition as assessed by the CPITN. In contrast no correlation was found with dental crossbite (IOTN and ICON). At last, there was significant correlation between overbite and periodontal condition. CONCLUSION: Significant correlations were found between malocclusions and periodontal condition. Within the limitation of this study one can suggest that malocclusions are risk marker for periodontal diseases. However, this study by virtue of its protocol cannot allow us to makeany inference about a cause/effect relationship between malocclusions and periodontal condition.

[Comparative odontometric data between Moroccan and Senegalese]. / Données odontométriques comparées chez des populations Marocaine et Sénégalaise.

INTRODUCTION: knowledge on the mesiodistal crown diameter of permanent teeth is relevant to clinical dentistry especially to orthodontics and prosthetic dentistry. Important variations have been reported in tooth crown size dimension between different populations. This seems to be related to complex interactions between genetic and environmental factors. The aim of this study was to compare the mesiodistal crown diameter of the permanent teeth in Moroccan and Senegalese populations. MATERIAL AND METHODS: the material for this study consisted of 104 pairs of study models of randomlyselected Moroccan (54 pairs) and Senegalese (50 pairs) children. The maximum mesiodistal dimensions were recorded for premolars, molars, canines and incisors in each study model using an electronic digital calliper (Mitutoyo, Japan) to the nearest 0.01 mm. The mesiodistal diameter of antimeric teeth was compared using paired sample t test. The independent sample t test was used to test for any difference between Moroccan and Senegalese regarding mesiodistal crown diameter of isomeric teeth. RESULTS: there were no significant differences in the mesiodistal diameter of antimeric teeth. The mesiodistal dimension of the canine was significantly larger in males than in females of both populations. The mesiodistal crown diameter of isomeric teeth was significantly larger in Senegalese in comparison to Moroccan. CONCLUSION: Further work with a larger number of non orthodontic subjects is needed to validate these findings.

[Gingival hypertrophy during orthodontic treatment: contribution of external bevel gingivectomy. Case report]. / L'hypertrophie gingivale au cours du traitement orthodontique: apport de la gingivectomie à biseau externe. Rapport de cas.

Gingival enlargement is a condition that commonly develops during orthodontic treatment. Orthodontic appliances are irritation and retention plaque factors holding up oral hygiene and control of gingival inflammation. Two cases of gingival hypertrophy in young Senegalese females undergoing orthodontic treatment with fixed appliances are described and treated by gingivectomy. This surgical procedure have led to morphological conditions of gingiva allowing better plaque control and the orthodontic treatment going on. Periodical controls in child and adolescent are required for healthy periodontium during orthodontic therapy. Collaboration between orthodontist and periodontist is one of the most important keys to successful treatment.

[Treatment of localized gingival hypertrophy induced by orthodontic appliances using modified Widman flap. A case report]. / Traitement de l'hypertrophie gingivale localisée associée au port de dispositifs orthodontiques par lambeau de Widman modifié. Rapport de cas.

Gingival enlargement is a condition that commonly develops during orthodontic treatment. Orthodontic appliances are irritation and retention plaque factors holding up oral hygiene and control of gingival inflammation. This case-report shows localized gingival hypertrophy in young Senegalese female undergoing orthodontic treatment with fixed appliances. Modified Widman flap associated with osseous recontouring have led to morphological conditions of gingiva allowing better plaque control and orthodontic treatment going on. Comfort and controlled haemostasis after periodontal surgery make this procedure a good choice for treatment of gingival hypertrophy. Collaboration between orthodontist and periodontist is required for successful therapeutic.

[Study of the characteristics of the food bolus in elderly subjects with complete dentures]. / Etude des caractristiques du bol alimentaire chez des sujets agés porteurs de prothèses complètes.

Many studies have shown that wearing of complete dentures impairs masticatory function. The aim of this study was to investigate the influence of complete denture wearing and ageing on masticatory performance. Masticatory performance was assessed by a granulometric method on 110 subjects divided into 3 groups according to dental state and age. The results show edentulous subjects have a masticatory performance worse than their congeneric of the same age. Indeed, the median of the distribution of the size of the particles is more important at the carriers of prostheses than at the toothed old subjects (P < 0.0001). On the other hand the extent of the distribution does not vary significantly between these 2 groups of subjects. The parameters of the masticatory performance do not vary in a statistically significant way between the old subjects and the young controls. There is thus no significant effect of the age on the parameters of the performance masticatory.