Faculty of Odontology

Objective: To compare partial and total tooth loss in dependent institutionalised elderly patients and identify any associated factors. Background: A poor oral health status, together with a reduction of autonomy can seriously affect the general health and increase the risk of death in elderly people. Those with total tooth loss and in need of assistance are the most at risk. Materials and methods: In 2004, a cross-sectional study of 321 elderly patients was conducted in longterm hospital services provided in Montpellier, France. Socio-demographic, behavioural, medical and oral health information was recorded for each patient. Multivariate logistic regression models were performed to test the relationship between those covariates and partial or total tooth loss. Pearson chi-squared tests were used for bivariate analyses. Results: The proportion of edentulousness was 26.9%; among these12.6% had no dentures. The factors significantly associated with edentulism were: an age 'older than 87 years' [odds ratio (OR) = 9.4], the presence of a nephropathy (OR = 6.8), and inadequate oral hygiene (OR = 0.1). The factors most significantly associated with partial tooth loss (at least 21 missing teeth) were 'cancerous disease' (OR = 9.9), the presence of a nephropathy (OR = 5.6) and the presence of a neurological disease (OR = 4.1). The factors significantly related to dentate status (20 or more natural teeth retained) were 'hypertension treatment' (OR = 2.4), and 'cortisone treatment' (OR = 0.2). Conclusion: General health problems as well as a poor oral condition were significant risk indicators for tooth loss among the long-term institutionalised elderly. This suggests that the number of remaining teeth has a strong effect on oral health-related quality of life.

Oral hygiene and the need for treatment of the dependent institutionalised elderly Objective: To assessing the oral hygiene and treatment needs of a geriatric institution in southern France. Background: For various reasons, the care demand from elderly people is low and difficult to determine, whereas their oral status would need long and complicated treatments. Materials and methods: From 2003 to 2004, a cross-sectional study of 321 elderly patients was conducted at several geriatric services of Montpellier, France. The clinical evaluation of dental status was recorded together with medical information. Dental and prosthetic hygiene, status of dentures, caries experience, dependence conditions and treatment needs were evaluated. Results: The prevalence of edentulism was 27%, with no gender difference (23% of the men and 29% of the women). Among them, 16.7% (upper jaw) and 18.1% (lower jaw) were totally edentulous with no denture. The mean number of decayed and missing teeth was 3.7 for men and 2.8 for women and 21.5 for men and 21.0 for women, respectively. The mean number of filled teeth was 0.8 for men and 1.3 for women, with no statistical difference according to gender for the three indexes. Most of the subjects needed prostheses (53%), 45.1% extractions and 30.6% conservative treatments. Only 2.4% did not need any treatment. Conclusion: The prevalence of edentulism was relatively low, while the need for prosthodontic rehabilitation, especially for men, was still very high. The dental hygiene was globally inadequate. This evaluation emphasises the care demand and the need for help in oral hygiene procedures for the dependent institutionalised elderly.

Please cite this article in press as:Carayon, D., et al., The age-related maturational pattern of the human subarcuate fossa (petromastoid canal). Preliminary results from the application of a new three-dimensional analytical approach. C. R. Palevol (2015), http://dx.

Aim: Modern clinical caries management involves early stage caries diagnosis and should fit with dental health policy. The objective of this study was to achieve early caries detection in enamel and dentine with a laser-based system (DIAGNOdent™ pen) first and secondary with a new fluorescence intra-oral camera (Soprolife®). A visual inspection with a loupe was used as control. Materials and methods: Following the consolidated standards of reporting trials recommendations, 628 occlusal fissures were included for analysis. Results: The sensitivity and specificity of both devices varied depending on the cutoff threshold of the caries score, and the ROC curve showed higher values for the Soprolife® than for DIAGNOdent™ pen. The values of the area under the curve decreased from 0.81 (Soprolife® in daylight) to 0.79 (Soprolife® in fluorescent mode) and 0.67 for DIAGNOdent™ pen. DIAGNOdent™ pen reproducibility (intra and inter-investigator) showed a wide dispersion, with many values scattered beyond the confidence limits (±2 SD), and the weighted kappa coefficient, which was quite low (0.58), confirmed this tendency. Conclusion: Caries prevalence in terms of public health policy is of interest and caries detection increased significantly when using an fluorescence-based intra-oral camera. Clinical significance: The clinical significance of these findings is that fluorescence could help improve caries diagnosis, reduce clinical misinterpretations, and finally benefit the patients.

Objectives:To investigate the relationship between caries prevalence and fissure sealants among 12-year-old German children at three educational levels. Methods:In 1998 a cross-sectional investigation which comprised 60 % of the 12-year-old children was performed in Heidelberg, Germany. The children attended three types of schools: Gymnasium, Hauptschule, and Realschule. The children received a dental examination. Teeth with caries experience were recorded according to WHO criteria, and teeth with a fissure sealant were also noted. Results:The mean number of fissure sealed teeth per child was 2.49 (Gymnasium), 2.31 (Realschule) and 1.17 (Hauptschule). In children who attended a Gymnasium the mean DMFT scores were the lowest (0.87 in children with fissure sealant and 1.31 in children without fissure sealant). The corresponding values for children who attended a Realschule were distinctly higher. The highest mean DMFT scores (2.14 and 3.48, resp.) were observed in children who attended a Hauptschule. The proportion of cariesfree children was higher in all three types of school when fissure sealants were present. Conclusions:In spite of a high prevalence of fissure sealants there is an unequal caries experience among 12-year-old children from different educational strata. To improve this situation, persons important to promotion of dental health should do all their part to ensure that fissure sealants are applied to permanent teeth as early as possible, especially when children have caries experience in their primary dentition.

Although the bond strength of self-adhesive bonding agents is inferior to that of other families of adhesives, it is still adequate for orthodontic purposes provided prior enamel etching is performed. Aim: To determine the efficacy of RelyXÔ Unicem Ò (3M) selfadhesive cement both in vitro and in vivo and to compare it with the combination of MIP Ò (3M), a moisture-insensitive primer, with a traditional hydrophobic adhesive, Transbond Supreme Low Viscosity Ò (3M). In vitro: Comparison of bonding results on 23 trial dentures using RelyXÔ Unicem Ò (3M) with bonding results on 29 trial

novo bone formation and de novo osteointegration to a portion of an implant that during the development of peri-implantitis suffered loss of bone-to-implant contact (BIC) and became exposed to microbial colonization [10]. When peri-implantitis occurs, several treatment strategies (mechanical, chemical, biochemical, physicochemical, etc.) can be employed for removal of attached biofilms on the surface of the implant [11]. Chemical treatments typically employed for debridement of contaminated surfaces include citric acid, tetracycline, doxycicline, saline, chlorhexidine and hydrogen peroxide [12]. These chemicals may be applied in conjunction with various mechanical treatments in order to facilitate biofilms removal. They include curettes, ultrasounds, and air-powder blasting, Er:YAG and CO 2 laser [13-15]. Recently, diode laser and phototherapy have been employed to remove biofilms with promising results [16,17]. The key factors for re-osseointegration [10,18] of an implant affected by peri-implantitis is not only to remove the bacterial biofilm, but also to regain the original implant surface roughness properties. Surface roughness analysis must be defined

The objective of the present study was to analyze the clinical outcomes of 447 monoblock ceramic chairside computer-aided design/computer-aided manufacture (CAD/CAM) reconstructions over a 7-year functional period. Of these reconstructions, 212 were peripheral crowns and 235 were endocrowns. Materials and Methods: The restorations were placed between 2003 and 2008 in a total of 323 patients. They were created using a chairside CAD/CAM method and the same materials in all cases. All of the crowns were manufactured and glued during the same clinical session by the same practitioner. Data were descriptively analyzed and survival probabilities were calculated using Kaplan-Meier statistics. Results: Of the 447 restorations, only 6 failures occurred, resulting in a success rate of 98.66%. All of the failures were the result of a partial ceramic fracture. Of the six ceramic fractures, five appeared on peripheral crowns and one on an endocrown. All fractures appeared in the first 24 months, including two in the first month. Log-rank test comparing incidence rates between crowns and endocrowns showed no significant differences (P = .08). Conclusion: This survival rate study reinforced the use of CAD/CAM full ceramic crowns and endocrowns on molars, showing a much more favorable survival rate for endocrowns.

Aim: To compare the levels, causes and the impact of stress from cohort of fifthyear dental students in the Faculties of Dental Medicine in Plovdiv, Bulgaria and Montpellier, France. Materials and methods: The questionnaire we used comprised the modified version of the 56-item Dental Environment Stress (DES) questionnaire. It was completed by fifth-year undergraduate dental students in both faculties in 2011 and 2016, totaling 335 dental students. A five-point Likert scale was used to record the responses from the subjects. Statistical analysis was performed with STATA version 14.1 (StataCorp, College Station, USA) specialized software. Results: The mean age of studied population was not significantly different between 2011 and 2016 (p=0.08). The common stress value per student was 1.74 (CI: 1.64; 1.84, range: 0.12; 4.50). It was higher in Plovdiv (1.79±0.81) than in Montpellier (1.63±0.66); it was statistically higher for girls (1.94±0.70) than for boys (1.49±0.77), and decreased b...

Objective A large number of digital tools supporting students have emerged over recent years which are encouraged in tutoring. A study conducted at the University of Montpellier (France) among 3rd, 4th, and 5th year dentistry students aimed primarily to identify the type of pedagogical support the students preferred according to their discipline. The secondary aim was to evaluate the student satisfaction after establishing a new pedagogical support. Materials and Methods A total of 165 questionnaires were completed. The main questions concerned pedagogical use of information technology and multimedia tools, choice of dentistry disciplines most justifying their use, and pedagogical gaps in these disciplines. Next, a program of pedagogical videos was developed for the most corresponding discipline. A satisfaction survey was finally conducted. Results Nearly 95.7% of students found online classes and E-learning via the virtual learning environment useful, with the most requested type b...

Effective sterilization of reusable instruments contaminated by Creutzfeldt-Jakob disease in dental care is a crucial issue for public health. The present cross-sectional study investigated how the recommended procedures for sterilization were implemented by French dental practices in real-world settings. A sample of dental practices was selected in the French Rhône-Alpes region. Data were collected by a self-questionnaire in 2016. Sterilization procedures (n = 33) were classified into 4 groups: (1) Pre-sterilization cleaning of reusable instruments; (2) Biological verification of sterilization cycles-Monitoring steam sterilization procedures; (3) Autoclave performance and practitioner knowledge of autoclave use; (4) Monitoring and documentation of sterilization procedures-Tracking and tracing the instrumentation. Answers were provided per procedure, along with the global implementation of procedures within a group (over 80% correctly performed). Then it was verified how adherence to procedure groups varied with the size of the dental practice and the proportion of dental assistants within the team. Among the 179 questionnaires available for the analyses, adherence to the recommended procedures of sterilization noticeably varied between practices, from 20.7% to 82.6%. The median percentages of procedures correctly implemented per practice were 58.1%, 50.9%, 69.2% and 58.2%, in Groups 1, 2, 3 and 4, respectively (corresponding percentages for performing over 80% of the procedures in the group: 23.4%, 6.6%, 46.6% and 38.6%). Dental practices ≥ 3 dental units performed significantly better (>80%) procedures of Groups 2 and 4 (p = 0.01 and p = 0.002, respectively), while no other significant associations emerged. As a rule, practices complied poorly with the recommended procedures, despite partially improved results in bigger practices. Specific training regarding sterilization procedures and a better understanding of the reasons leading to their non-compliance are needed.

Adolescence is closely associated with a high risk of caries. The identification of specific bacteria in an oral microniche, the interdental space of the molars, according to carious risk can facilitate the prediction of future caries and the anticipation of the progression or stabilization of caries in adolescents. A cross-sectional clinical study according to the bacteriological criteria of interdental healthy adolescents and carious risk factors—low and high—using a real-time polymerase chain reaction technique was conducted. The presence of 26 oral pathogens from the interdental microbiota of 50 adolescents aged 15 to 17 years were qualitatively and quantitatively analyzed. Bacteria known to be cariogenic (Bifidobacterium dentium, Lactobacillus spp., Rothia dentocariosa, Streptococcus cristatus, Streptococcus mutans, Streptococcus salivarius, Streptococcus sobrinus, and Streptococcus wiggsiae) did not present differences in abundance according to carious risk. Periodontal bacter...

Background: Despite extensive prevention programs, dental hygiene remains inadequate, particularly among children under the age of six, and early childhood caries (ECC) are still a concern. Oral hygiene behavior and preventive practices seem difficult to change at a family level. Aim. The present study aimed to better understand the reasons behind this behavior and to identify the different barriers to the implementation of adequate preventive measures. Methods: A qualitative study was conducted in the pediatric dentistry service of the Montpellier University Hospital (France) in 2019. A thematic analysis concerning three domains was performed: family environment, dental literacy, and oral hygiene. Results. The main barriers encountered by the parents were, respectively, (1) a weakness in the organization of familial life, together with a low-medium family income and a lack of authority, (2) ignorance of the necessity of treating carious primary teeth, and (3) a lack of time for bru...

Pre-eclampsia (PE), a pregnancy-specific hypertensive disorder, characterized by the development of placental endothelial dysfunction, remains a major source of maternal and perinatal morbidity and mortality, especially in low- and middle-income settings. Periodontal disorders during pregnancy, and particularly periodontal pathogens, may be related to the risk of PE. Standard oral hygiene methods, based mainly on the joint use of toothbrushes and interdental brushes, reduce periodontal inflammatory risk and modulate the dysbiosis of the oral microbiome. The aim of this trial is to compare the PE outcomes in high-risk pregnant women receiving oral prophylactic measures to a control group. This trial is designed as a two-arm, parallel, cluster randomized controlled trial with the antenatal obstetric clinic as the unit of randomization and an allocation ratio of 1:1. The pregnant women will be included at 3 months of pregnancy and will be followed throughout the pregnancy. The primary ...

The aim of this study, applied in the field of periodontal diseases, was first to analyze the fatty acid levels in two groups of patients and then to propose a method for selecting the most relevant predictors. Two groups of patients, 29 with moderate or severe periodontitis and 27 who served as controls, were clinically examined, and their fatty acids in serum were measured by gas chromatography. The levels of these 12 fatty acids were the variables of the analysis. Logistic regression, together with the area under the receiver operating characteristic (ROC) curves, allowed determining a composite score which led to a subset of the most relevant covariables. The fatty acid levels differed significantly between the 2 groups in multivariate analysis (P=0.03) and the best logistic model was obtained with only 3 predictive variables: arachidonic acid, linoleic acid, and DHA. Fatty acid levels in serum of patients were significantly different according to the presence of moderate or sev...

In clinical situations carious dentine tissues can be discriminated by most caries fluorescence detection tools, including a new fluorescence intra-oral camera. The objectives of this study were: (i) to analyze the Raman spectra of sound, carious, and demineralized dentine, (ii) to compare this spectral analysis with the fluorescence variation observed when using a fluorescence camera, and (iii) to evaluate the involvement of the Maillard reaction in the fluorescence variations. The first positive hypothesis tested was that the fluorescence of carious dentine obtained using a fluorescence camera and the Raman spectra variation were closely related. The second was that the variation of fluorescence could be linked with the Maillard reaction. Sound dentine, sound dentine demineralized in aqueous nitric acid solution, carious soft dentine, sound dentine demineralized in lactic acid solution, sound dentine demineralized in aqueous nitric acid solution and immersed in methylglycoxal solution, and sound dentine demineralized in aqueous nitric acid solution and immersed in methylglycoxal and glucose solutions, were studied using micro-Raman spectroscopy. Modifications in the band ratio of amide, phosphate, and carbonate were observed in the decayed and demineralized groups compared with the sound dentine group. The results indicate that a close relationship exists between the Maillard reaction and fluorescence variation.

The aim of the present study was to evaluate the effectiveness of using a mineralized bone cortical allograft (MBCA), with or without a resorbable collagenous membrane derived from bovine pericardium, on alveolar bone remodeling after immediate implant placement in a dog model. Methods: Six mongrel dogs were included. The test and control sites were randomly selected. Four biradicular premolars were extracted from the mandible. In control sites, implants without an allograft or membrane were placed immediately in the fresh extraction sockets. In the test sites, an MBCA was placed to fill the gap between the bone socket wall and implant, with or without a resorbable collagenous membrane. Specimens were collected after 1 and 3 months. The amount of residual particles and new bone quality were evaluated by histomorphometry. Results: Few residual graft particles were observed to be closely embedded in the new bone without any contact with the implant surface. The allograft combined with a resorbable collagen membrane limited the resorption of the buccal wall in height and width. The histological quality of the new bone was equivalent to that of the original bone. The MBCA improved the quality of new bone formation, with few residual particles observed at 3 months. Conclusions: The preliminary results of this animal study indicate a real benefit in obtaining new bone as well as in enhancing osseointegration due to the high resorbability of cortical allograft particles, in comparison to the results of xenografts or other biomaterials (mineralized or demineralized cancellous allografts) that have been presented in the literature. Furthermore, the use of an MBCA combined with a collagen membrane in extraction and immediate implant placement limited the extent of post-extraction resorption.