Dyschromies colorées du secteur antérieur : étiopathogénie et prise en charge

La demande esthétique de nos patients est en continuelle croissance et se trouve être un motif récurrent de consultation, en particulier chez les jeunes adultes. Parmi ces motifs de consultation resssort la présence de taches colorées dans le secteur antérieur. Dans le cadre d’une dentisterie moderne, le praticien doit être à même d’apporter des solutions efficaces conjuguant : satisfaction du patient, en dissimulant ces défauts; et économie tissulaire, avec l’approche la moins dommageable, laissant idéalement possible et aisée toute ré-intervention. L’objectif de cet article est de faire un point sur les taches colorées de l’émail, c’est-à-dire les colorations jaunes, orangées ou brunes. Nous montrerons qu’il est important de bien connaître l’étiopathogénie de ces taches, afin de mettre en oeuvre la thérapeutique la plus appropriée pour atteindre nos objectifs et satisfaire le patient

Donner le sourire à nos jeunes patients : stratégies préventives et thérapeutiques

Les atteintes des structures dentaires ou les édentations peuvent perturber le développement psychique d’un enfant et les conséquences fonctionnelles engendrées peuvent s’exprimer à divers niveaux et degrés variables. Les traitements conservateurs et réhabilitations prothétiques permettent un développement physiologique et psychologique normal de l’enfant. Ces thérapeutiques rendent le sourire et une apparence normale grâce à des reconstitutions esthétiques, à la compensation de dents antérieures absentes et au maintien de la dimension verticale. Elles rétablissent les fonctions perturbées et préviennent leurs conséquences néfastes, assurant ainsi une croissance harmonieuse. La dimension esthétique revêt une importance capitale dans ces traitements mais ne doit pas se faire au détriment de la pérennité de la restauration. Le maintien d’organes dentaires en bonne santé demeure le meilleur garant du sourire de nos jeunes patients

Characterization of the dentin microstructural components: a FIB-SEM analysis.

International audienceIntroduction Dentin is the main tissue of the tooth. It is composed of peritubular dentin (PTD), intertubular dentin (ITD) and tubules (T). This microstructure has been mainly studied in 2D using optical microscopy [1], Scanning Electronic Microscopy (SEM) [2] and Atomic Force Microscopy (AFM) [3]. Among the few 3D studies of its architecture, tubules have been observed and quantified within the first 350 µm from the dentin-enamel junction (DEJ) using confocal laser scanning microscopy (CLSM) by Vennat et al. [4] It has been shown that the tubules have a complex geometry with many channels connecting them. Even in the localized area near DEJ, dentin shows properties gradients. In order to widen the knowledge of the dentinal microstructure, there is a need to investigate the three components of dentin (PTD, ITD and T) within the whole dentinal tissue. As FIB-SEM allows imaging the three components of dentin in 3D, a FIB-SEM study has been led in order to investigate their organization in 3D. FIB-SEM has already been used on dentin [5], [6] but we argue that more parameters can be extracted from the data obtained, especially concerning the PTD and ITD and the objective of this paper is to prove it

Methodological Proposal to Assess Gingival Thickness in Children

International audienceInadequate gingival thickness (GT) may lead to gingival recession. Thus, early identification of patients/ teeth at risk would be advantageous. In adults, the probe's visibility through the marginal gingiva (reference test) has been considered a reliable criterion to describe a thin gingiva. This study aimed to evaluate in children two more convenient methods: the whitening of the attached gingiva with coronal labial traction (GW test) and the visibility of the gingival blood supply (BS test).Materials and Methods: In 69 children, the GT of primary and/or permanent central and lateral incisors, first primary molars and/or first premolars was assessed with the three tests. The sensitivity and specificity of the GW and BS tests and their odds ratio with probing were calculated.Results: According to probing, 39% of children in the studied population had thin gingiva. The GW and BS tests reported different percentages of GT compared to probing, except for primary teeth, maxillary permanent incisors and mandibular first premolars, where the GW test exhibited a comparable percentage. The sensitivity of GW and BS tests was 37% and 19%, respectively, when compared to probing, while the specificity was 84% and 96%, respectively.Conclusion: The GW and BS tests could be used for first-line diagnosis of thin gingiva; if the results are negative, probing should be implemented

Bond strength and interfacial morphology of orthodontic brackets bonded to eroded enamel treated with calcium silicate–sodium phosphate salts or resin infiltration

International audienceObjective: To investigate the shear bond strength (SBS) of orthodontic brackets bonded to eroded enamel treated with preventive approaches and to examine the enamel/bracket interfaces.Materials and Methods: Ninety-one brackets were bonded to seven groups of enamel samples: sound; eroded; eroded+treated with calcium silicate–sodium phosphate salts (CSP); eroded+infiltrated by ICON®; eroded+infiltrated by ICON® and brackets bonded with 1-month delay; eroded+infiltrated by an experimental resin; and eroded+infiltrated by an experimental resin and brackets bonded with 1-month delay. For each group, 12 samples were tested in SBS and bond failure was assessed with the adhesive remnant index (ARI); one sample was examined using scanning electron microscopy (SEM).Results: Samples treated with CSP or infiltration showed no significant differences in SBS values with sound samples. Infiltrated samples followed by a delayed bonding showed lower SBS values. All of the values remained acceptable. The ARI scores were significantly higher for sound enamel, eroded, and treated with CSP groups than for all infiltrated samples. SEM examinations corroborated the findings.Conclusions: Using CSP or resin infiltration before orthodontic bonding does not jeopardize the bonding quality. The orthodontic bonding should be performed shortly after the resin infiltration

Emerging Nanotechnology in Non-Surgical Periodontal Therapy in Animal Models: A Systematic Review

Periodontitis is one of the most prevalent inflammatory diseases. Its treatment, mostly mechanical and non-surgical, shows limitations. The aim of this systematic review was to investigate the effect of nanoparticles as a treatment alone in non-surgical periodontal therapy in animal models. A systematic search was conducted in Medline/PubMed, Web of Science, The Cochrane Library and Science Direct. The eligibility criteria were: studies (i) using nanoparticles as chemotherapeutic agent or as delivery system; (ii) including preclinical controlled animal model (experimental periodontitis); (iii) reporting alveolar bone loss; (iv) written in English; and (v) published up to June 2019. Risk of bias was evaluated according to the SYstematic Review Centre for Laboratory Animal Experimentation. On the 1324 eligible studies, 11 were included. All reported advantages in using nanoparticles for the treatment of periodontitis, highlighted by a reduction in bone loss. Agents modulating inflammation seem to be more relevant than antibiotics, in terms of efficiency and risk of antibiotic resistance. In addition, poly(lactic-co-glycolic acid) or drugs used as their own carrier appear to be the most interesting nanoparticles in terms of biocompatibility. Risk of bias assessment highlighted many criteria scored as unclear. There are encouraging preclinical data of using nanoparticles as a contribution to the treatment of periodontitis

Commercially Available Fluoride-Releasing Restorative Materials: A Review and a Proposal for Classification

Resin composite and glass ionomer cement (GIC) are the most commonly used dental materials to perform direct restorations. Both have specific characteristics that explain their popularity and their limits. More than 20 years ago, the first attempt (followed by others) to combine the advantages of these two families was performed with compomers, but it was not very successful. Recently, new formulations (also called ‘smart materials’) with claimed ion release properties have been proposed under different family names, but there are few studies on them and explanations of their chemistries. This comprehensive review aims to gather the compositions; the setting reactions; the mechanical, self-adhesive, and potential bulk-fill properties; and the ion release abilities of the large existing families of fluoride-releasing restorative materials and the new restorative materials to precisely describe their characteristics, their eventual bioactivities, and classify them for an improved understanding of these materials. Based on this work, the whole GIC family, including resin-modified and highly viscous formulations, was found to be bioactive. Cention N (Ivoclar Vivadent, AG, Schaan, Lietschentein) is the first commercially available bioactive resin composite