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The objective of this study was to evaluate the variations in the degree of conversion (DC) of a light-curing composite resin when the thickness or the translucency of lithium disilicate-enriched glass-ceramic veneers are modified. IPS e. max® CAD blocks of the MT-A2, LT-A2 and MO1 types were cut to obtain four slices with thicknesses ranging from 0.6 mm to 1 mm. A strictly light-curing composite resin (G-aenial Universal Injectable) was injected in the empty part of a silicone mold so that the veneer could then be inserted under digital pressure to the stop. A 40 s light cure (1400 mW/cm2) was then performed. Resin samples were analyzed using Fourier transform infrared (FTIR) spectroscopy. When the degree of translucency of the ceramic was modified, a decrease in the resin conversion rate was noted, but with a non-significant global p-value (p = 0.062). Interestingly, the degree of conversion of the light-curing composite resin was also modified when the ceramic’s thickness increased, especially when it was over 1 mm (DC0.6 > DC0.7 > DC0.8 > DC1; p < 0.0001). This confirms that the degree of conversion of a bonding material is very dependent on the ceramic’s thickness. Contradictory data are, however, found in the literature, where there are reports of an absence of a difference between the DC obtained with thicknesses of ceramics of 0.7 and 2 mm.

Adipose-derived mesenchymal stromal cells (ASC) transplant to recover the optimal tissue structure/function relationship is a promising strategy to regenerate tissue lesions. Because filling local tissue defects by injection alone is often challenging, designing adequate cell carriers with suitable characteristics is critical for in situ ASC delivery. The aim of this study was to optimize the generation phase of a platelet–lysate-based fibrin hydrogel (PLFH) as a proper carrier for in situ ASC implantation and (1) to investigate in vitro PLFH biomechanical properties, cell viability, proliferation and migration sustainability, and (2) to comprehensively assess the local in vivo PLFH/ASC safety profile (local tolerance, ASC fate, biodistribution and toxicity). We first defined the experimental conditions to enhance physicochemical properties and microscopic features of PLFH as an adequate ASC vehicle. When ASC were mixed with PLFH, in vitro assays exhibited hydrogel supporting cell migration, viability and proliferation. In vivo local subcutaneous and subgingival PLFH/ASC administration in nude mice allowed us to generate biosafety data, including biodegradability, tolerance, ASC fate and engraftment, and the absence of biodistribution and toxicity to non-target tissues. Our data strongly suggest that this novel combined ATMP for in situ administration is safe with an efficient local ASC engraftment, supporting the further development for human clinical cell therapy.

(1) Background: In developed countries, the prevalence of apical periodontitis (AP) varies from 20% to 50% for reasons that could be associated with the apical periodontitis microbiota ecology. (2) Methods: We performed a clinical study in the Odontology department of Toulouse hospital in France, to sequence the 16S rRNA gene of AP microbiota and collect clinical parameters from 94 patients. Forty-four patients were characterized with a PAI (periapical index of AP severity) score lower or equal to 3, while the others had superior scores (n = 50). (3) Results: The low diversity of granuloma microbiota is associated with the highest severity (PAI = 5) of periapical lesions (Odds Ratio 4.592, IC 95% [1.6329; 14.0728]; p = 0.001; notably, a lower relative abundance of Burkholderiaceae and a higher relative abundance of Pseudomonas and Prevotella). We also identified that high blood pressure (HBP) is associated with the increase in PAI scores. (4) Conclusions: Our data show that a low diversity of bacterial ecology of the AP is associated with severe PAI scores, suggesting a causal mechanism. Furthermore, a second risk factor was blood pressure associated with the severity of apical periodontitis.

ispartof: J Am Acad Dermatol vol:87 issue:4 pages:872-874 ispartof: location:United States status: published

Objective The study aimed to describe and to analyze the first morbidity and mortality review (MMRs) set up within a Dental University Hospital using detailed case reports to highlight the benefits of MMRs for patients, practitioners, teachers and to implement appropriate protocols to prevent recurrence. Materials and Methods The MMRs were performed within the dentistry departments of the hospital over the 1-year study period. Each case was reviewed according to a protocol based on a tool defined by the Clinical Risk Unit and the Association of Litigation and Risk Management (ALARM). Results Four cases were selected based on an oral report by a doctor from the dental service, a downstream service, or by the attending physician. The first case report related to a patient who suffered a breathing shock. The second concerned a tooth inhalation by a young disabled boy. The third was a therapeutic failure instigated by a student during a tooth preparation, and the fourth case involved an unexpected face-to-face meeting between a prisoner accompanied by police guards and an ancient victim at the dental hospital. Discussion Clinical incidents were investigated with the ALARM protocol. This process is also less focused on the individual who makes the error and more on contributing systemic factors. The systematic analysis of cases associated with bibliographic reviews improves learning and performance outcomes. Clear answers were given in response to the problems raised during these MMRs. Conclusion In dental hospitals, the culture of MMRs needs to be integrated into resident training like in medical hospitals.

Saliva plays a key role in food absorption and digestion mainly due to both its enzymes and microbiota. The main objective of this study was to compare the oral microbiota and salivary parameters between men and women in response to feeding. To answer this question, we set up a pilot study on 10 male and 10 female subjects to examine the role of saliva in glycaemia physiology. Biological parameters and the microbiotal composition of saliva were analyzed in fasted and fed states. The results show that the level of blood glucose was not different between men and women in the fasted state (88.00 mg/dL ± 6.38 vs 87.00 mg/dL ±8.07, p = 0.9149) or in the fed state (102.44 mg/dL ± 14.03 vs 116.9 mg/dL ± 25, p = 0.1362). Free fatty acids (FFA 0.15 mmol/L ± 0.15 vs 0.07 mmol/L ± 0.07, p = 0,0078), cholesterol (0.53 mmol/L ± 0.30 vs 0.15 mmol/L ± 0.14, p

SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome is a poorly known disease with cutaneous and osteo-articular manifestations requiring a multidisciplinary care. The aim of this study was to review the case reports that have described oral manifestations in patients suffering for this syndrome. A systematic review of case reports was performed on PubMed and Science Direct on January 2020 among all the articles dealing with the disease. In vitro, preclinical, and clinical studies have not been included to select only the case reports. Eighteen articles, published between 1999 and 2019, were included. All the patients presented mandibular osteomyelitis or sclerosis, associated with various other symptoms such as trismus, temporomandibular joint arthritis, or dysphagia. The data highlight the high variability in the disease's manifestations between people and also in the treatments applied. Knowing the orofacial signs of the SAPHO syndrome, the dental surgeon has a crucial role in the diagnosis procedure and must take place in the multidisciplinary medical team involved in the patient following. Some care adaptations are needed for oral interventions in these patients, depending on their treatments and their handicap. Key Points • Orofacial manifestations of SAPHO syndrome mainly occur on the mandible. • In cases of mandible sclerosis, decorticalization surgeries may be performed. • Oral care are encouraged, especially the preventive treatments to limit the necessity of surgeries. • The complexity in the management of patients suffering for a SAPHO syndrome concerns the oral manifestations, the patient general health and the treatments he has to take every day.

The aim of this study was to analyze the link between oral microbiota and obesity in humans. We conducted a pilot study including 19 subjects with periodontitis divided into two groups: normo-weighted subjects (NWS) with a body mass index (BMI) between 20 and 25 (n = 9) and obese subjects (OS) with a BMI &gt, 30 (n = 10). Obesity was associated with a poor oral health status characterized by an increased number of missing teeth and a higher score of periodontal-support loss associated with dysbiotic oral microbiota (39.45 ± 3.74 vs. 26.41 ± 11.21, p = 0.03 for the Chao 1 index). Oral microbiota taxonomic analysis showed that the abundance of the Capnocytophaga genus was higher (2.47% ± 3.02 vs. 0.27% ± 0.29, p = 0.04) in OS compared to NWS. Obese females (OF) were characterized by an increase in the Streptococcus genus (34.12% ± 14.29 vs. 10.55% ± 10.42, p = 0.05) compared to obese males (OM), where the Neisseria genus was increased (5.75% ± 5.03 vs. 58.05% ± 30.64, p = 0.008). These first data suggest that sex/gender is determinant in the link between oral dysbiotic microbiota and obesity in patients with periodontitis. Our results could lead to recommendations concerning therapeutic strategies for obese patients with periodontitis following the sex/gender.

The aim of this study was to analyze the link between oral microbiota and obesity in humans. We conducted a pilot study including 19 subjects with periodontitis divided into two groups: normo-weighted subjects (NWS) with a body mass index (BMI) between 20 and 25 (n=9) and obese subjects (OS) with a BMI >30 (n=10). The abundance of the Capnocytophaga genus, found in oral microbiota by taxonomic analysis, was higher (2.47% ± 3.02 vs 0.27% ± 0.29, p=0.04) in OS compared to NWS. Decayed teeth (2.25 ± 2.21 vs 0, p=0.04) were significantly increased in obese females (OF) compared to obese males (OM) associated with a dysbiotic oral microbiota (39.45 ± 3.74 vs 26.41 ± 11.21, p=0.03 for the Chao 1 index). OF were characterized by an increase in the Streptococcus genus (34.12% ± 14.29 vs 10.55% ± 10.42, p=0.05) compared to OM where the Neisseria genus was increased (5.75% ± 5.03 vs 58.05% ± 30.64, p=0.008). These first data suggest that the sex gender is determinant in the link between oral dysbiotic microbiota and obesity. Our study proposes an adaption of therapeutic strategies for obese patients with periodontitis following the sex gender.

International audience; Non-stoichiometric nanocrystalline apatites present enhanced bioactivity compared to stoichiometric hydroxyapatite. The purpose of this work was to modify the calcium phosphates (CaP) generally used to prepare bioactive ceramics in the aim of obtaining a biomimetic apatite powder. Hydroxyapatite (HA) powder, amorphous tricalcium phosphate (amTCP) powder and a blend of these two were modified by means of an innovative, simple, “green” carbonation process, involving water and high-pressure CO2 (80 bar). This process induced a modification of the CaP, which is sensitive to the environment in which it is located and, in particular, to the pH variations that occur during the treatment phase (decrease in the pH) and during the degassing phase (return to neutral pH). FTIR and Raman spectroscopy, XRD and SEM analyses showed that, depending on the type of initial CaP powder, high-pressure CO2 treatment led to the formation of different types of calcium phosphate phases. This process allowed partial dissolution of the initial powder, mainly of TCP when present, and precipitation of a new CaP phase. HA and HA/amTCP powders were transformed into a mixture of OCP and immature carbonated apatite (PCCA) phases, including OCP maturation/transformation into PCCA. In the case of amTCP powder, a DCPD phase was also present due to the high TCP solubility and an earlier precipitation during the degassing step. This work shows the great potential of such an innovative low-temperature and high-pressure process to transform HA, HA/TCP and TCP powder into bioactive biphasic ceramics composed of OCP and PCCA similar to bone mineral.

International audience; The composition of dental resin-based composite (RBC) matrix is partly responsible for many clinical failures in restorations, which may come from dimensional variation or instability in a wet environment. The objective of this study is therefore to evaluate the thermal stability over time of four dental RBC with different matrices. Silicone cylinders were filled with four different materials and then photopolymerized. To simulate ageing in the buccal environment, half of the samples were placed in a dark place at 37°C for 45 days in sealed compartments containing 2 ml of water. All the RBC produced were subjected to thermogravimetric analysis to measure the loss of mass as a function of temperature. Bis-GMA-based resins and Ormocer materials have similar curves before and after soaking in humid atmosphere. The curves of the UDMA resin are different before and after water ageing, meaning that water imbibition has modified the structure of the composite and its degradation. Even if many curves are similar within the same RBC at different polymerization times or at different pre- and post-ageing times, it is rare to observe a common kinetics between two different composites. Our results show good wet stability of polymerized dental RBC according to the manufacturer’s instructions, although the UDMA-based materials show more variation. It therefore seems that Ormocer resin composite with mass placement have ageing properties that can compete with those of conventional composites whereas those incremented on 2 mm layers are more sensitive to the time necessary for polymerization.

Objectives For more than twenty years, dental practice-based research networks (D-PBRN) have helped to structure clinical research in private practice. They bring together practitioners working in several structures and may include a greater number of subjects. The aims of this study were thus to systematically explore the scientific production from dental private practices in general and to map and describe the D-PBRN activity worldwide. Data sources Two research procedures were carried out in parallel. The first was conducted as a scoping review to examine peer-reviewed literature indexed in the PubMed database and the second was performed on the World Wide Web to identify the main characteristics of the networks (location, scientific production…). Study selection 368 publications were identified among which 202 were published by PBRN members and the others by private practitioners not affiliated to any network. 210 (57 % of the included articles) were produced in the USA. A higher number of diverse centers are involved in each study when it is conducted by a PBRN (59.06 ± 66.59 vs. 13.51 ± 31.58 for networks and independent teams, respectively; p Conclusions Although dental practice-based research has grown over the years, the number of D-PBRN worldwide remains low. Even if it requires some investment to produce research in dental offices, this type of networks helps to fill the gap between private practice and research and to improve knowledge on oral health. Relevance The mapping of all the dental PBRN together with the research topics studied throughout the world make the relevance of this article. The ways to improve practice-based research in dentistry are also discussed in the paper.

SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome is a poorly known disease with cutaneous and osteo-articular manifestations requiring a multidisciplinary care. The aim of this study was to review the case reports that have described oral manifestations in patients suffering for this syndrome. A systematic review of case reports was performed on PubMed and Science Direct on January 2020 among all the articles dealing with the disease. In vitro, preclinical, and clinical studies have not been included to select only the case reports. Eighteen articles, published between 1999 and 2019, were included. All the patients presented mandibular osteomyelitis or sclerosis, associated with various other symptoms such as trismus, temporomandibular joint arthritis, or dysphagia. The data highlight the high variability in the disease's manifestations between people and also in the treatments applied. Knowing the orofacial signs of the SAPHO syndrome, the dental surgeon has a crucial role in the diagnosis procedure and must take place in the multidisciplinary medical team involved in the patient following. Some care adaptations are needed for oral interventions in these patients, depending on their treatments and their handicap. Key Points • Orofacial manifestations of SAPHO syndrome mainly occur on the mandible. • In cases of mandible sclerosis, decorticalization surgeries may be performed. • Oral care are encouraged, especially the preventive treatments to limit the necessity of surgeries. • The complexity in the management of patients suffering for a SAPHO syndrome concerns the oral manifestations, the patient general health and the treatments he has to take every day.

International audience; SAPHO is an acronym for Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis. The syndrome is difficult to diagnose because it may present many different manifestations in adults and children. Its origin is still unknown, although some infectious, genetic and immune hypotheses have been put forward. We report the case of a 49‐year‐old woman with SAPHO syndrome, who developed a serious cutaneous allergy following the insertion of a removable partial denture (RPD). The oral care and treatment of this patient are described.

International audience; Tooth inhalation remains a rare incident but it may occur during dental care, especially in children. We report here the case of a four-year-old boy with Down syndrome who came to the hospital after a dental trauma. During the extraction procedure, he aspired his maxillary incisor without presenting any signs of respiratory distress and was discharged by the surgical team, who thought that he had swallowed the tooth. Three weeks later, he was admitted to the emergency service because of a pulmonary infection. Two endoscopy interventions under general anesthesia were necessary to recover the foreign body inside the left lung. Because of the multiple symptoms associated with the trisomy 21 syndrome (general hypotonia, impaired immunity, etc.), practitioners should be very mindful of aspiration risks and complications during dental care. The systematic prescription of lung radiography would prevent the onset of pulmonary infections and enable an earlier intervention.

AIM: To assess whether periodontal treatment can lead to clinical, glycaemic control and quality of life improvements in metabolically unbalanced diabetic patients (type 1 or type 2) diagnosed with periodontitis. METHODS: In this open-labelled randomized controlled trial, diabetic subjects (n = 91) were given "immediate" or "delayed" periodontal treatment (full-mouth non-surgical scaling and root planing, systemic antibiotics, and oral health instructions). The main outcome was the effect on glycated haemoglobin (HbA1C ) and fructosamine levels. The General Oral Health Assessment Index and the SF-36 index were used to assess quality of life (QoL). RESULTS: Periodontal health significantly improved after periodontal treatment (p < 0.001). Periodontal treatment seemed to be safe but had no significant effects on glycaemic control based on HbA1C (adjusted mean difference with a 95% confidence interval (aMD) of 0.04 [-0.16;0.24]) and fructosamine levels (aMD 5.0 [-10.2;20.2]). There was no obvious evidence of improvement in general QoL after periodontal treatment. However, there was significant improvement in oral health-related QoL (aMD 7.0 [2.4;11.6], p = 0.003). CONCLUSION: Although periodontal treatment showed no clinical effect on glycaemic control in this trial, important data were provided to support periodontal care among diabetic patients. Periodontal treatment is safe and improves oral health-related QoL in patients living with diabetes. ISRCTN15334496.

Objective Elite athletes are prone to develop oral diseases, which could increase the risk for injuries. The aim of this study was to evaluate the oral health and the composition of oral microbiota of elite rugby players compared to the general population. Methods We set up a case-control study by screening 24 professional rugby players (PRG) and 22 control patients (CG) for dental and gingival examinations and performed a taxonomic analysis and a predicted functional analysis of oral microbiota. Results The Decay, Missing and Filled (DMF) teeth index (5.54 ± 6.18 versus 2.14 ± 3.01; p = 0.01) and the frequency of gingivitis (58,33% versus 13.63%) were significantly increased in PRG compared to CG. PRG were characterized by a dysbiotic oral microbiota (Shannon Index: 3.32 ± 0.62 in PRG versus 3.79 ± 0.68 in CG; p = 0.03) with an increase of Streptococcus (58.43 ± 16.84 versus 42.60 ± 17.45; p = 0.005), the main genus implicated in caries. Predicted metagenomics of oral microbiota in rugby players was suggestive of a cariogenic metagenome favourable to the development of caries. Conclusions Our study shows that the oral health of PRG was poorer than the general population. PRG are characterized by a dysbiotic oral microbiota with an increase of the relative abundance of Streptococcus genus, positively correlated to the weight and negatively correlated to the diversity of oral microbiota. Clinical significance Dental screening should be included in the medical follow-up of professional rugby players as a part of their health management. New strategies such as using probiotics like Lactobacillus could help to control the dysbiosis of oral microbiota.

International audience; L'objectif de l'ouvrage est d'apporter aux chirurgiens-dentistes et aux stomatologistes les données anatomiques indispensables à la réalisation de leurs actes chirurgicaux, sans oublier le soutien anatomique apporté aux prothésistes dentaires. L'ouvrage s'adresse aussi bien aux étudiants qu'aux praticiens. Les premiers pourront apprendre les caractéristiques fondamentales de l'anatomie et entrevoir les fonctions qui s'y rapportent. Les praticiens, quant à eux, pourront avec l'expérience acquise en pratique quotidienne revenir aux sources pour mieux comprendre l'importance de l'agencement inter-arcades au cours des traitements. Ce livre comprend trois grands chapitres : une première partie fondamentale basée sur la description des dents humaines adultes, une deuxième partie plus clinique alliant anatomie et fonction, enfin une troisième partie mettant en avant les notions d'esthétiques liées à la présence des dents. Il a été rédigé avec un souci constant de mise en avant de l'iconographie et d'une grande praticité d'utilisation par son lecteur.