Treatment of a periodontal intrabony pocket in man by a mucoperiostal free graft combined with a calcium phosphate implant

A two-walled intrabony pocket was treated by a mucoperiostal free graft interposed between the curetted root surface and a calcium phosphate implant. The eighteen months follow up radiography showed complete healing of the bone defect, a normal periodontal ligament space, an uninterrupted lamina dura and a well-formed septum. The use of a mucoperiostal free graft may supply the wounded area with different cells such as fibroblasts, indifferenciated mesenchymal cells, periostal cells, intercelular fibers and biochemical substances such as glucoaminoglycans, proteoglycans etc...Une poche parodontale à trois murs a été traitée par l’interposition d’un greffon mucoperiosté entre la surface radiculaire surfacée et un implant de phosphate de calcium. A dix-huit mois, la radiographie de contrôle a montré un comblement total du défaut osseux, un espace ligamentaire normal, une lamina dura continue et un septum interdentaire bien formé. Il est possible que le greffon mucopériosté agisse comme un réservoir de cellules (fibroblastes, cellules mésenchymateuses indifférenciées, cellules périostées), de fibres intercellulaires et de substances biochimiques (glycoaminoglycanes, protéoglycanes etc...)

Comparison of the dental health status of 8 to 14-year-old children in France and in Jordan, a country of endemic fluorisis

In the present paper, data obtained from a survey dealing with dental carie, dental fluorosis and gingival health, involving 2618 Jordanian schoolchildren, aged 8 to 14, were compared with data from another survey dealing with 1058 schoolchildren of the same age groups living in a non-fluoridated area in the west of France. As regards dental carie in temporary teeth,  up to the age of 12, the dft and dfs scores were higher in France than in Jordan. Over the age of 12, the difference was no longer significant. As regards dental carie in permanent teeth, the data showing that Jordanian children are less subject to caries than the French were very highly significant. Also, it was shown that caries index in girls was higher than in boys.These data were not significant in the French survey, but highly significant in the Jordanian investigation.A possible explanation is that, due to the custom of the country, boys in Jordan drink much more tea (with high fluoride content) than girls. As regards gingival health, an interesting finding was that, compared to the French children, the percentage of Jordanian children presenting gingivitis is remarkably low. The fluoride content of the dental plaque might play a restricting and preventing role.Les résultats d’une enquête sur la carie dentaire, la fluorose et la gingivite, menée en Jordanie chez 2618 écoliers de 8 à 14 ans, ont été comparés avec ceux d’une enquête menée en France chez 1058 écoliers de mêmes âges, dans l’Ouest de la France, où l’eau de boisson n’est pas fluorée. En ce qui concerne la carie des dents temporaires, les indices en France sont plus élevés qu’en Jordanie, mais la différence n’est plus significative après l’âge de 12 ans. Pour les dents permanentes, les résultats indiquent, de façon très significative, que les enfants Jordaniens sont moins atteints par la carie que les français. Les filles, dans les deux enquêtes, sont plus atteintes que les garçons, mais la différence n’est pas significative dans l’enquête française, alors qu’elle est très significative dans l’enquête jordanienne. La raison pourrait être qu’en Jordanie, la coutume du pays veut que les garçons participent très tôt aux rites de la vie quotidienne et boivent davantage de thé (très fluoré) que les filles. En ce qui concerne la gingivite, le pourcentage des enfants atteints en Jordanie est très bas, comparé à ce qu’il est en France. Le contenu en fluor de la plaque pourrait jouer un rôle limitatif et protecteur

Hydroxyapatite biomaterial implanted in human periodontal defects: an histological and ultrastructural study

The purpose of the present work was to study the response of human periodontium to hydroxyapatite biomaterial particles (180-200 µm). The biomaterial was implanted in two infraosseous periodontal defects (two patients) after clearing of the granulation tissue. At two months post-surgery, biopsies were studied using light and electron microscopy. No sign of inflammation was observed, the biomaterial aggregates were surrounded either by typical fibroblasts or larger phagocytotic cells with phagocytosis vesicles containing biomaterial crystals. These intracellular crystals were noticeably smaller than the nonphagocytized ones. Some of the phagocytized crystals showed morphological signs of intracellular dissolution. The spaces between the crystals constitutive of the aggregates were filled with organic substance containing collagen fibers.Le présent travail a pour but d’étudier la réponse du parodonte humain à des particules d’hydroxyapatite de 180 à 200 µm. Le biomatériau a été implanté dans deux poches parodontales infraosseuses (deux patients) après élimination du tissu de granulation. Deux mois après l’intervention, des biopsies ont été étudiées en microscopie photonique et en microscopie électronique. Aucun signe d’inflammation n’a été décelé, les agrégats de biomatériau sont bordés soit de fibroblastes, soit de cellules phagocytaires, de taille plus importante, avec des vésicules de phagocytose renfermant des cristaux de biomatériau. Ces cristaux intracellulaires sont notablement plus petits que les cristaux non phagocytés. La morphologie de certains cristaux phagocytés traduit l’existence d’une dissolution intracellulaire. Les espaces entre les cristaux constitutifs des agrégats sont comblés par une substance organique contenant des fibres de collagène

Etude structurale, ultrastructurale et microanalyse de perles d’émail multiples

Numerous enamel drops and compound enamel pearls were found on the radicular proximal faces of maxillary molars and mandibular third molars of a young woman. Enamel and dentin of compound pearls as well as cementum next to drops and pearls presented the same structure and ultrastructure as enamel, dentin and cementum of the corresponding teeth. Microanalysis did not reveal differences between enamel of the mother tooth and enamel of drops and pearls. The enamel drops had no incremental growth lines.Cementum next to enamel drops and compound enamel pearls was acellular and covered occasionally with a thick layer of cellular cementum. Only enamel drops were partially covered by acellular cementum.Close to the enamel drops and at their surface, numerous fusing globular calcifications were observed.Formation of enamel drops and compound enamel pearls on dental root surfaces is rare. The simultaneous presence of numerous enamel drops and some compound enamel pearls on several roots of molars in the same denture seems to be an exceptionnal phenomenon. The involved factors inducing enamel formation remain still unknown. The multitude of both enamel drops and compound enamel pearl might be due to constitutionnal prédisposition.De nombreuses perles d’émail simples et composées, localisées sur les faces proximales des racines des molaires maxillaires et des dents de sagesse mandibulaires d’une même personne ont été étudiées en microscopie classique, microscopie électronique à balayage et microanalyse. L’émail et la dentine des perles composées ainsi que le cément jouxtant les perles ont la même structure et ultrastructure que l’émail, la dentine et le cément des dents porteuses, la microanalyse ne montre pas de différences entre l’émail des perles et l’émail des dents. Les perles d’émail simples ne possèdent pas de lignes de croissance. Le cément, à proximité des perles d’émail simples et composées, est de type acellulaire, doublé d’une couche, parfois épaisse, de cément cellulaire. Seules, les perles d’émail simples sont recouvertes partiellement par du cément acellulaire. On observe de nombreux calcoglobules à la surface et à proximité des perles d’émail simples.La sécrétion d’émail radiculaire sous la forme de perles simples ou composées est un phénomène rare. L’observation simultanée, dans une même denture, de nombreuses perles simples et composées constitue un fait nouveau et semble exceptionnel.Le ou les facteurs déclenchant un tel processus n’ont pu être déterminés jusqu’à présent. Une prédisposition constitutionnelle, dont la preuve reste à apporter, pourrait en être responsable

Enquête épidémiologique sur la santé bucco-dentaire à Fada N’Gourma (Burkina Faso)

In 1983 an investigation involving a homogeneous population sample from a western city of Burkina Faso has been performed in 1983 in order to estimate the oral health status of the population cut off from any dental assistance and to assess the importance of traditional practices in the city.The investigation, performed using World Health Organization techniques (WHO, 1977) involved 354 subjects, male and female, divided into age groups from 10 to 54. It was shown that: although the oral hygiene level was very low and no dental treatments were performed, caries level was very low - although gingivitis rate was high, advanced periodontitis rate was low - The frequency of interincisive diastema (one subject out of 4 in the 15-19 age group), the progressive decline of tooth cutting, a traditional practice, in town people but the large extent of cola use (one adult out of two).The present data will be used as base-line reference to evaluate the incidence of a dental care and prevention program which has just started in the same city of Burkina Faso.En 1983, une enquête portant sur un échantillon homogène d’une ville de l’Ouest du Burkina Faso a été menée par l’Aide Odontologique Internationale pour évaluer l’état bucco-dentaire d’une population, en l’absence de service odontologique organisé, et l’incidence de pratiques traditionnelles dans cette population citadine.L’enquête, menée selon la méthode proposée par l’Organisation Mondiale de la Santé (OMS, 1977), a porté sur 354 sujets des deux sexes, répartis par tranches d’âge de 10 à 54 ans. Elle a montré: un indice de carie très bas, malgré une très mauvaise hygiène orale et l’absence de soins dentaires - un taux de prévalence des parodontopathies avancées peu élevé comparativement à celui de la gingivite - la fréquence d’une particularité orthodontique, le diastème interincisif (1 sujet sur 4 dans la tranche d’âge 15-19 ans) - la disparition progressive d’un rite traditionnel, les tailles dentaires, dans la population citadine, mais la proportion importante (1 adulte sur 2) d’utilisateurs de la noix de cola, utilisée comme excitant.La présente enquête est destinée à servir de base de comparaison au terme d’un programme de soins et de prévention bucco-dentaires mis en place actuellement

Anomalies de formation de l’émail chez les sujets présentant des fentes maxillaires

A structural and ultrastructural study of teeth located in the vicinity of maxillary cleft and teeth located outside the cleft region, was made in 12 cases, using correlated light microscopy, microradiography and SEM. Ail teeth directly involved in cleft process presented gross hypoplasia of the crown where the enamel surface was hypomineralized. Globular calcified masses of different radiodensity were seen on the hypomineralized enamel surface. The teeth located outside the cleft region presented less pronounced anomalies constituted by isolated or groupe microhypoplasia on hypomineralized enamel. The observation of enamel pearl was not pathognomonic of maxillary cleft.Une étude structurale et ultrastructurale des dents voisines des fentes maxillaires et des dents situées à distance des fentes maxillaires a été réalisée dans 12 cas, à l’aide de techniques convergentes adaptées aux tissus calcifiés (microscopie photonique, microradiographie, M.E.B.). Les dents directement impliquées dans le processus de la fente présentent toutes d’importantes hypoplasies coronaires et une surface d’émail immature. Des calcifications globulaires, de radiodensité hétérogène, siègent à la surface de l’émail hypoplasié.Les dents situées à distance des fentes présentent des anomalies plus discrètes constituées par des microhypoplasies isolées ou groupées sur un émail hypomature. L’observation d’une perle d’émail à la bifurcation radiculaire d’une molaire supérieure n’est pas pathognomonique des fentes maxillaires

Scanning Electron Microscopy and Electron Probe Microanalyses of the Crystalline Components of Human and Animal Dental Calculi

A review of the use of scanning electron microscopy (SEM) and electron probe microanalyses in the study of dental calculus showed that such studies provided confirmatory and supplementary data on the morphological features of human dental calculi but gave only limited information on the identity of the crystalline or inorganic components. This study aimed to explore the potential of combined SEM and microanalyses in the identification of the crystalline components of the human and animal dental calculi. Human and animal calculi were analyzed. Identification of the crystalline components were made based on the combined information of the morphology (SEM) and Ca/P molar ratios of the crystals with the morphology and Ca/P molar ratio of synthetic calcium phosphates (brushite or DCPD; octacalcium phosphate, OCP; Mg-substituted whitlockite, -TCMP; CO3-substituted apatite, (CHA); and calcite. SEM showed similarities in morphological features of human and animal dental calculi but differences in the forms of crystals present. Microanalyses and crystal morphology data suggested the presence of CaCO3 (calcite) and CHA in the animal (cat, dog, tiger) and of OCP, -TCMP and CHA in human dental calculi. X-ray diffraction and infrared (IR) absorption analyses confirmed these results. This exploratory study demonstrated that by taking into consideration what is known about the crystalline components of human and animal dental calculi, combined SEM and microanalyses can provide qualitative identification

Le rôle de la consommation du thé dans la fluorose dentaire en Jordanie

2.516 children of both sexes, six to fourteen years old, were examined in Jordan in the course of an epidemiological study. 81,11 % of girls and 76,43% of boys presented severe forms of dental fluorosis according to DEAN’s index.Drinking water analysis revealed fluoride concentrations ranging from 0,27 to 1,4 mg F/l. These concentrations are neighbouring optimum tolerated fluoride supplementation in drinking water. However high annual temperature mean and ten hours daily sunshining must also be taken in consideration. For social and climatic reasons, jordanian children drink daily high quantities of tea. Analysis of tea prepared on jordanian way revealed a concentration of 1,2 mg F/l. This continuous intake of fluoride might explain the high severity of dental fluorosis in Jordan.Dans le cadre d’une enquête sur la fluorose dentaire en Jordanie, 2.516 enfants de six à quatorze ans, filles et garçons, répartis sur l’ensemble du pays ont été examinés. 81,11% des filles et 76,43% des garçons se situent dans les deux classes les plus sévères de la fluorose selon la classification de DEAN.L’analyse de l’eau de consommation a relevé des concentrations en fluor variant de 0,27 mg F/l à 1,4 mg F/l, selon les régions et les sources. Ces concentrations en fluor ne dépassent pas le seuil tolérable pour éviter la fluorose dentaire. Mais à cela, s’ajoute une moyenne annuelle de température élevée ( 14 º à 24º C) et une moyenne d’ensoleillement journalier de dix heures. Pour des raisons sociales et climatiques, la population jordanienne consomme dès l’enfance, une grande quantité de boisson journalière, essentiellement sous forme de thé. Le dosage de fluor dans le thé préparé selon la méthode jordanienne a donné une concentration moyenne de 1,2 mg F/l.Cette absorption continue de thé apporte un excès de fluor permettant vraisemblablement d’expliquer en partie la sévérité de la fluorose dentaire en Jordanie

A pigmented calcifying cystic odontogenic tumor associated with compound odontoma: a case report and review of literature

<p>Abstract</p> <p>Background</p> <p>Pigmented intraosseous odontogenic lesions are rare with only 47 reported cases in the English literature. Among them, pigmented calcifying cystic odontogenic tumor, formerly known as calcifying odontogenic cyst, is the most common lesion with 20 reported cases.</p> <p>Methods</p> <p>A case of pigmented calcifying cystic odontogenic tumor associated with odontoma occurring at the mandibular canine-premolar region of a young Japanese boy is presented with radiographic, and histological findings. Special staining, electron microscopic study and immunohistochemical staining were also done to characterize the pigmentation.</p> <p>Results</p> <p>The pigments in the lesion were confirmed to be melanin by Masson-Fontana staining and by transmission electron microscopy. The presence of dendritic melanocytes within the lesion was also demonstrated by S-100 immunostaining.</p> <p>Conclusion</p> <p>The present case report of pigmented calcifying cystic odontogenic tumor associated with odontoma features a comprehensive study on melanin and melanocytes, including histochemical, immunohistochemical and transmission electron microscopic findings.</p

Review of nanomaterials in dentistry: interactions with the oral microenvironment, clinical applications, hazards, and benefits.

Interest in the use of engineered nanomaterials (ENMs) as either nanomedicines or dental materials/devices in clinical dentistry is growing. This review aims to detail the ultrafine structure, chemical composition, and reactivity of dental tissues in the context of interactions with ENMs, including the saliva, pellicle layer, and oral biofilm; then describes the applications of ENMs in dentistry in context with beneficial clinical outcomes versus potential risks. The flow rate and quality of saliva are likely to influence the behavior of ENMs in the oral cavity, but how the protein corona formed on the ENMs will alter bioavailability, or interact with the structure and proteins of the pellicle layer, as well as microbes in the biofilm, remains unclear. The tooth enamel is a dense crystalline structure that is likely to act as a barrier to ENM penetration, but underlying dentinal tubules are not. Consequently, ENMs may be used to strengthen dentine or regenerate pulp tissue. ENMs have dental applications as antibacterials for infection control, as nanofillers to improve the mechanical and bioactive properties of restoration materials, and as novel coatings on dental implants. Dentifrices and some related personal care products are already available for oral health applications. Overall, the clinical benefits generally outweigh the hazards of using ENMs in the oral cavity, and the latter should not prevent the responsible innovation of nanotechnology in dentistry. However, the clinical safety regulations for dental materials have not been specifically updated for ENMs, and some guidance on occupational health for practitioners is also needed. Knowledge gaps for future research include the formation of protein corona in the oral cavity, ENM diffusion through clinically relevant biofilms, and mechanistic investigations on how ENMs strengthen the tooth structure