Prescription of Antibiotics in Oral-Dental Practice: Case of the Dental Practice at the Coyah Prefectoral Hospital in the Republic of Guinea 2019-2020

Introduction: Antibiotics are medications that have the property of destroying bacteria or preventing their proliferation. The aim of this study is to evaluate antibiotic prescriptions in oral practice: case of the dental office of the Coyah prefectural hospital. Methods: This is a descriptive cross-sectional study which took place from August 2019 to January 2020 inclusive, i.e. a duration of six (6) months, during which 400 patients were identified. Results: Our results revealed a frequency of 70% of antibiotic prescriptions. The 16 - 25-year-old age group was the most dismayed, at 47.25% and with an average age of 27.78 years. Men represent 55% compared to 45% of women, i.e. sex ratio of 1.22. Pulp gangrene was the most common pathology in 55% of cases. The most prescribed family was Betalactamine or 61.71% and the most represented molecules were Amoxicillin with 56.10% followed by Metronidazole or 34.16%. And the favorable prognosis was observed in 99% of cases. Conclusion: Prescription should always be based on the benefit-risk ratio. This prescription by practitioners aims to prevent or eradicate infections and pain in order to obtain a good therapeutic result.

Study on the Treatment of Reusable Care Equipment in Public and Private Dental Practices in the City of Conakry

Introduction: The effective sterilization of reusable instruments in dental care is a crucial issue for public health. The aim of this study was to contribute to improving the processing conditions of reusable care instruments in dental practices in the city of Conakry. Methods: We carried out an observational and cross-sectional study of a descriptive type lasting three months from January to April 2022 in public and private dental practices approved for activities. Results: A total of 48 dental practices were surveyed, including 7 public and 41 private. 91.67% had the trays for instrument sterilization. 77.08% had a sterilization device. The instruments were: cleaned 100%, disinfected 70.83%, sterilized 20.83% and 20.83% reused the instruments without being sterilized. 72.97% sterilized the instruments at the end of the day. 50% of respondents declared that there were six stages of sterilization. According to standard standards, one dental office or 2.70% respected the normal sterilization process and 13.51% respected the duration and temperature. The storage quality was inadequate at 95.83%. 95.83% of dental practices are at high risk of contamination. The difficulties encountered by staff in daily activity during our study were lack of hygienists (87.50%), insufficient material resources (58.33%), and lack of protocol procedure (45.83%). Conclusion: This study allowed us to note shortcomings of dental surgeons in the process of processing reusable care materials.

The Dental Absces: Epidemiological, Clinical and Therapeutic Aspects at the Dental Office of the Prefectoral Hospital of Siguiri in 2021 in the Republic of Guinea

Introduction: A dental abscess is a collection of pus located in the tissues surrounding the tooth roots. The aim of this work is to describe the epidemiological, clinical and therapeutic aspects of dental abscess in order to contribute to the management of patients suffering from this pathology at the dental office of the Siguiri Prefectural Hospital. Methods: This was a retrospective descriptive study lasting 2 months carried out on the registers of patients received between October 2017 and October 2020 at the dental office of the Siguiri prefectural hospital. Results: 4690 patient files were identified during the study, of which 546 met our selection criteria, i.e. a frequency of 11.64%. During our study, we found 51.83% female compared to 48.17% male, i.e. a sex ratio of 1.07. 54.21% of our patients resided in rural communes compared to 45.76% for the urban commune. The age group most affected was that of 16 - 25 years old or 33.69%. Swelling, pain and functional discomfort were the reasons for consultation in all patients followed by other associated reasons in 41.21%. The premolar-molar group was the most represented, i.e. 86.70%. 80.04% of our patients presented an acute abscess compared to 19.96% of chronic cases. Antibiotic, analgesic, and mouthwash were prescribed in all patients during the study followed by 96.37% of cases prescription of steroidal anti-inflammatory drugs. 93.04% of causal teeth were extracted followed by 6.78% of cases of conservative treatment in our study. In our study, 80.95% of our patients had a good post-therapeutic outcome. Conclusion: This study highlights the need for prevention and early management of dental abscesses.

Role of viruses in periodontitis:An extensive review of herpesviruses,human immunodeficiency virus,coronavirus-19,papillomavirus and hepatitis viruses

Periodontitis is the inflammation of the supporting structures around the dentition.Several microbial agents,mostly bacteria,have been identified as causative factors for periodontal disease.On the other hand,oral cavity is a rich reservoir for viruses since it contains a wide variety of cell types that can be targeted by viruses.Traditionally,the focus of research about the oral flora has been on bacteria because the most widespread oral diseases,like periodontitis and dental caries,are outcomes of bacterial infection.However,recently and especially after the emergence of coronavirus disease 2019,there is a growing tendency toward including viruses also into the scope of oral microbiome investigations.The global high prevalence of periodontitis and viral infections may point out to a concomitant or synergistic effect between the two.Although the exact nature of the mechanism still is not clearly understood,this could be speculated through the manipulation of the immune system by viruses;hence facilitating the furthermore colonization of the oral tissues by bacteria.This review provides an extensive and detailed update on the role of the most common viruses including herpes family(herpes simplex,varicella-zoster,Epstein-Barr,cytomegalovirus),Human papillomaviruses,Human immunodeficiency virus and severe acute respiratory syndrome coronavirus 2 in the initiation,progression and prognosis of periodontitis.

Klippel-feil:A syndrome in the occipital-cervical spine field and its dentofacial manifestations

Klippel-Feil syndrome(KFS) is defined by congenital cervical vertebral spine fusion and is seen with a wide spectrum of dental manifestations and craniofacial profiles. Previous studies on lateral cephalograms have documented an association between fusion of the cervicalvertebrae and deviations in the craniofacial profile in non-syndromic patients with severe malocclusion. To our knowledge, no previous studies have described the craniofacial profile including the cranial base of KFS patients on lateral cephalograms. Therefore KFS and its craniofacial and dental manifestations were described according to existing literature and additionally the craniofacial profile and cranial base was analysed on lateral cephalograms of two patients with KFS. According to the literature the dental manifestations of KFS-patients included oligodontia, overjet, cross bite, open bite and deep bite. The craniofacial profile was clinically described as reduced lower facial height, midfacial hypoplasia, and mandibular prognathia. The analyses of the two lateral cephalograms showed increased mandibular inclination, increased vertical jaw-relationship, increased jaw angle and maxillary retrognathia. The cranial base was normal in both cases. The sagittal jaw relationship and mandibular prognathia varied between the two cases. The literature review and the analyses of the two lateral cephalograms have shown that deviations in the occipital and cervical spine field as KFS were associated with deviations in the teeth and craniofacial profile.

Tooth agenesis and craniofacial morphology in preorthodontic children with and without morphological deviations in the upper cervical spine

AIM: To analyze differences in prevalence and pattern of tooth agenesis and craniofacial morphology between non syndromic children with tooth agenesis with and without upper cervical spine morphological deviations and to analyze associations between craniofacial morphology and tooth agenesis in the two groups together. METHODS: One hundred and twenty-six pre-orthodontic children with tooth agenesis were divided into two groups with(19 children, mean age 11.9) and without(107 children, mean age 11.4) upper spine morphological deviations. Visual assessment of upper spine morphology and measurements of craniofacial morphology were performed on lateral cephalograms. Tooth agenesis was evaluated from orthopantomograms.RESULTS: No significant differences in tooth agenesis and craniofacial morphology were found between children with and without upper spine morphological deviations(2.2 ± 1.6 vs 1.94 ± 1.2, P > 0.05) but a tendency to a different tooth agenesis pattern were seen in children with morphological deviations in the upper spine. In the total group tooth agenesis was associated with the cranial base angle(n-s-ba, r = 0.23,P < 0.01), jaw angle(ML/RLar, r = 0.19, P < 0.05), mandibular inclination(NSL/ML, r =-0.21, P < 0.05), mandibular prognathia(s-n-pg, r = 0.25, P < 0.01), sagittal jaw relationship(ss-n-pg, r =-0.23, P < 0.5), overjet(r =-0.23, P < 0.05) and overbite(r =-0.25, P < 0.01). CONCLUSION: Etiology of tooth agenesis in children with upper spine morphological deviations was discussed. The results may be valuable for the early diagnosis and treatment planning of non syndromic children with tooth agenesis.

Construction of the recombinant vector carrying herpes simplex virus thymidine kinase and cytokine genes expressed in cell line Tca8113

Objective: To construct expression vector containing fusion genes of herpes simplex virus thymidine kinase(Hsv-tk), Interleukin-2(IL-2) with internal ribosome entry sites(IRES), and to assess their expression in cell line Tca8113. Methods: IL-2 cDNA was obtained by reverse transcription. Hsv-tk, IL-2 and IRES genes were amplified by PCR. The purified amplification products were inserted into pGEM-T-Easy, and transformed into E.coli JM109. The purified recombinant plasmids were identified by restriction endonucleases. The recombinant plasmids were digested and pEGFP-N 3 were linearized, DNA fragments of Hsv-tk, IRES and IL-2 were ligated into linearized pEGFP-N 3, and then transferred into E.coli JM109. The recombinant tk-IL-2 genes were cloned separately and introduced into the expression vector pEGFP-N 3 containing GFP. The recombinant vectors were identified by their restriction sites through PCR. The plasmids pEGFP-TI was also transfected into Tca8113 cells by calcium phosphate method for the expression of fusion proteins. Fusion genes expressing vector PL(TI)SN was generated by the fusion of HSV-tk, IRES and IL-2 with the use of DNA recombination technology. The recombinant retroviruses were transferred into Tca8113 cells by lipofectamine. The positive clones were obtained after G418 selection and named Tca/TI respectively. Results: The pEGFP-TI pasmid was identified respectively by restriction endonucleases, and their fragment sizes were 1 120 bp and 450 bp. The pEGFP-TI pasmid as templates were amplified respectively by PCR, and their PCR products were 1 120 bp and 450 bp. The pEGFP-TI vectors were used to transfect Tca8113 cell, and the cells with fluorescence accounted for 60% of the total amount. Conclusion: pFGFP-tk-IRES-IL-2 expressing vector is easy to assess the expression of tk-IRES-IL-2-GFP fusion protein localization in transfected cells. The successful construction of expressing vector containing fusion genes of Hsv-tk, IRES and IL-2 may be beneficial for gene therapy in cell line Tca8113.

The Effect of Ultrasonic Method for Preparing Root Canals:A Scanning Electron Microscopic Evaluation

Sixteen fresh extracted human teeth paired according to their anatomic locations,were divided into two groups at random.The root canais of the teeth in Group 1 were preparedwith an ultrasonic unit and those of Group 2 with hand instruments.Then,the specimens wereobserved under a scanning electron microscope and their pnotographs were taken.Blindevaluation of cleanness was performed for each canal.Statistical dnalysis of the data indicatesthat the canal walls were cleaner in Group 1 than in Group 2 and that the ultrasonic preparationtook less time.

Salivary levels of cortisol and chromogranin A in patients with burning mouth syndrome: A case-control study

Burning mouth syndrome (BMS) is a poorly understood oral pain disorder characterized by a painful burning sensation in the oral cavity without any mucosal abnormalities. In this study, we evaluated the salivary cortisol and chromogranin A (CgA) levels of patients with BMS in comparison with age-matched controls. Subjects (n = 114) included 81 BMS patients and 33 controls. Patients with BMS were further classified into a subgroup of subjects who occasionally feel a burning sensation (BMS 1), and a subgroup of subjects who always feel a burning sensation (BMS 2). Salivary cortisol and CgA levels were measured using ELISA kits. All individuals with BMS had significantly higher cortisol and CgA levels than the controls did. Furthermore, when comparing the controls with each BMS subgroup, salivary levels of cortisol were significantly higher in both subgroups than controls. In contrast, the level of CgA was significantly higher in the BMS 2 subgroup only. Multiple regression analysis revealed a significant independent association between salivary levels of cortisol and BMS even after adjustment for gender, antidepressant or antianxiety drug use and hypertension (drug-treated). The study revealed that a significant association was observed between salivary cortisol levels and BMS.

Study of the Duration of Treatment in Drug Prescriptions Received in Pharmacies in Dakar

The prescription must include the name of the drugs or products prescribed, dosage form, dosage, directions for use and duration of treatment. However, sometimes errors can occur that can have consequences for the health of patients. Our study concerns the use of medical prescriptions received in pharmacies in the Dakar department. The survey was conducted in 90 pharmacies in these communes, which represent one third of the 270 pharmacies in the department of Dakar. This allowed us to study 2700 prescriptions. The study took place from 1 December 2016 to 30 June 2017, i.e. over a period of 7 months. Our results show that neurologists and urologists have a longer average treatment time than other specialists, with an average of 120 days and 90 days of treatment respectively. Then, the specialists who take a long time the drug represent more than 27%, and require renewal of the drug. In 63.90% of the cases, no notification on the duration of treatment was given by the prescriber. Only 5.39% were only given the mention “to be renewed”. At the end of our analysis, we can say that the prescription must be perfectly legible to avoid confusion by the patient or the pharmacist. The pharmacist then participates in the therapeutic education of the patient and thus helps him/her to live better with his/her disease. Therefore, socio-professional health associations and organisations must provide more continuous training on prescribing to ensure good compliance and above all avoid people buying medicines in the parallel circuit in order to better control health expenditure.

Management of Congenital Malformations of the Face in the GbèkèRegion (Côte d’Ivoire)

Background: Congenital malformations of the face are relatively frequent in the Gbèke region (C&ocirc;te d’Ivoire). Objectives: Identify the epidemiological aspects, describe the management method, distinguish the anatomical-clinical aspects and identify the therapeutic methods and their results. Material and methods: A retrospective and descriptive study was carried out over a period of 8 years (2012-2019) in the Odontostomatology and Maxillofacial Surgery Department of the University Hospital Centre (Bouaké) and in the “Jean Baptiste Vatelot” religious hospital of Bouaké. The study concerned patients whose congenital malformations of the face had undergone primary surgery. Results: 439 patients were collected, i.e. an annual frequency of 54.88 cases per year. The sex ratio was 1.07 and the mean age was 6.82 years (range 5 months to 48 years). There were 434 (98.86%) cleft lips and palates and 5 (1.14%) Tessier’s clefts. Among the cleft lip and palate, there were 214 (49.31%) cleft lip, 127 (29.26%) cleft palate and 93 (21.43%) combined cleft lip and cleft palate. Surgical treatments numbered 532 and included 293 (55.08%) cheiloplasties, 113 (21.24%) pushback uranostaphyloraphies and 90 (16.92%) double flap palatoplasties. Complications were noted in 43 cases. Conclusion: Congenital malformations of the face were managed relatively late in the Gbèkè region with satisfactory results. Ante-natal diagnosis, early psychotherapy and a better screening system should allow an improvement of the management.

Altered thermal sensitivity in facial skin in chronic whiplash-associated disorders

There is a close functional relationship between the jaw and neck regions and it has been suggested that trigeminal sensory impairment can follow whiplash injury.Inclusion of manageable routines for valid assessment of the facial sensory capacity is thus needed for comprehensive evaluations of patients exposed to such trauma.The present study investigated facial thermal thresholds in patients with chronic whiplash-associated disorders（WADs）with both a qualitative method and quantitative sensory testing（QST）.Ten women with pain and dysfunction following a whiplash injury were compared to 10 healthy age-matched women.Thermal detection thresholds were assessed by qualitative chair-side testing and by QST according to the method-of-limits.Seven test sites in the facial skin（overlying each trigeminal branch bilaterally,and the midpoint of the chin）were examined.The detection warm and cold thresholds were defined as the mean values of 10 individual thresholds.For the WAD patients,the qualitative assessment demonstrated both reduced and increased sensitivity compared to the healthy,whereas QST systematically showed significantly higher detection thresholds（i.e.,decreased sensitivity）for both cold and warm stimuli.For the individuals who were assessed as having increased sensitivity in the qualitative assessment,the QST displayed either normal or higher thresholds,i.e.,decreased sensitivity.The results suggest that QST is more sensitive for detecting thermal sensory disturbances in the face than a qualitative method.The impaired thermal sensitivity among the patients corroborates the notion of altered thermal detection capacity induced by WAD-related pain.

Oral Healthcare Renunciation and Socioeconomic Determinants

The unequal access to healthcare in general and oral healthcare, in particular, is a true public health concern. Thus, it is important to assess the oral healthcare renunciation and socioeconomic determinants to take appropriate measures. A cross-sectional, descriptive population-based study of 300 households was carried out between April 28, 2016, and May 28, 2016, according to WHO’s guidelines (Protocol 1997), in Senegal adapted form. Results showed that 18.23% of householders report that their household members have foregone oral healthcare. Among those who renounced care, 51.5% did so for care costs (24.2%) or remoteness of health facilities (27.3%) reasons. Therefore, dental treatment renunciation was independently associated to income level, age, sex, marital status, and types of oral healthcare coverage. This study’s analysis shows that oral healthcare renunciation depends primarily on the financial aspect and the remoteness of health structures. Still, there are other important socio-anthropological parameters that should be investigated.

Vitamin D Insufficiency among Women Post-Partum in Northern Sweden—A Public Health Concern

Pregnancy and post-partum represent a period of susceptibility for vitamin D insufficiency. This study investigated S-25 [OH] D levels in women in northern Sweden 4 weeks post-partum and its association with selected background factors. Blood from 100 healthy women were analyzed for iron status and serum levels of S-25[OH] D using ionization-mass spectrometry (HPLC-APCI-MS). 【50 nmol/L was categorized as insufficiency and 【25 nmol/L as deficiency. Maternal BMI, dietary habits, fungal infections during pregnancy, and infant birth characteristics were collected using questionnaires and medical charts. 58% were vitamin D insufficient whereas 10% had deficiency. Insufficiency was most common during winter (OR = 2.77;95% CI = 1.1-6.96) and women with deficiency reported lower milk consumption;11.3 ± 22.8 intakes per months vs. 34.0 ± 28.9 for those above 25 nmol/L (p &deg;49'N. The odds of being insufficient were increased during winter whereas milk consumption was negatively associated with deficiency. The low vitamin D-levels particularly during winter is a public health concern. From a public health perspective it has to be considered whether dietary advices alone should be modified or if supplementation with vitamin D during pregnancy and the post-partum period also is needed.

Dietary intake of advanced glycation endproducts(AGEs)and cancer risk across more than 20 anatomical sites:A multinational cohort study

Dear Editor,In the European region,which shares 22.8%of the global cancer burden for 10%of the global population,there were around 4.4 million new cancer cases and 1.9 million deaths from cancer in 2020[1].The reasons for the high cancer incidence rates are complex;however,diet and dietary components are among the main contributors to cancer risk[2].In modern-day living,a growing proportion of people include in their diets ultra-processed foods.Byproducts of food processing and home-prepared foods are so-called dietary advanced glycation endproducts(AGEs),which are reactive metabolites emerging during the breakdown of reducing sugar.AGEs production is preponderant in dry high-heat processes(e.g.,baking,roasting);hence foods such as cakes,crisps,crackers,cereal products,meat and meat-derived products represent a major source of dietary AGEs[3].