Rapports de cas de santé bucco-dentaire

Introduction: One of the main goals of root canal therapy is to remove pulp tissue, layers of infected dentin and biofilms attached to the root canal surface, yet this requires enlargement of root canals for mechanical instrumentation and access of irrigants. Reports indicate that larger size files and file tapers allow for increased penetration of irrigants albeit at the greater risk of complications including ledge formation, instrument separation, perforation, and root fracture.

Background: In this case report, a mandibular right cuspid presented with sensitivity to percussion and a deep coronal restoration.

Methods: The tooth was conservatively accessed and then patency and working length were established utilizing a size 10/.02 hand file. For preservation of tooth structure, maintenance of original canal anatomy, and to decrease the risk of complications normally seen in standard endodontics, a no shaping endodontic treatment utilizing the Gentle Wave® Procedure was performed. No shaping with endodontic files was performed. Only the Gentle Wave Procedure was employed to clean and disinfect the root canal system. The canal was obturated using a single cone technique with gutta-percha and BC Sealer™.

Results: Post-procedure radiographs of the non-shaped canal show no voids and a flush fill depicting a clinically significant obturation.

Discussion: This case report demonstrates the ability of the Gentle Wave Procedure to clean anterior teeth without the use of instrumentation for shaping thereby conserving the natural tooth structure and decreasing the chance of complications as seen in standard endodontic treatment.

The concept that invasive dental procedures may cause infective endocarditis was first suggested in 1923. With the advent of antibiotics, the idea that antibiotic prophylaxis can be used before invasive dental procedures to reduce the risk of infective endocarditis. The decision to use preoperative prophylactic antibiotics is controversial. Some researchers have written that this decision is based on the assumption that the patient does not have large medical risk factors that could affect the patient’s defense mechanisms. Various risk factors include poorly controlled diabetes, renal disease, severe alcoholism, immunosuppressive diseases (e.g. leukemia, lymphoma, or advanced malignancy), and the use of chemotherapeutic agents or other immunosuppressive drugs. The objective of the present literature review is to evaluate the current practice in cases in which antibiotic prophylaxis is necessary and essential. Antibiotics have played a key role, and have undoubtedly revolutionized many aspects of health care. However, its use and overuse has resulted in several public health problems. In addition, its risks and side effects have inadvertently, and negatively impact on the quality of life of patients. We conclude that the way antibiotic prophylaxis is used nowadays is much more precautionary than effective in protecting bacterial invasion. Randomized clinical trials are needed to see if prophylaxis assists and protects the patient or is only a medication with inadequate efficacy.

Herpes simplex labialis is one of the common infectious diseases caused by Herpes Simplex Virus (HSV) type 1 and is commonly contracted during childhood or adolescence. These infections are manifested as primary and recurrent episodes and affects the vermillion border of the lip in about 90% of cases, the palate in 5% of cases, and elsewhere above the chin or on the oral mucosa rarely. In primary and recrudescent HSV-associated disease, the symptoms may range from subclinical to debilitating and life-threatening, depending on the host’s immune responses or competence level. Several factors, including exposure to intense sunlight, psychological stress or immunosuppression may trigger a recurrence. A case of recurrent herpes labialis with acute herpetic gingivostomatitis during pregnancy and the role of oral physician in managing such cases are described in the present article.

Background: Periodontal disease affects 50% to 80% of the world population and is a host immune system inflammatory response associated with a change within the gingival sulcus or periodontal pocket. Conventional treatment and homecare programs are inadequate in controlling the biofilm that causes this disease. Direct medication delivery has been shown to modify the periodontal biofilm, decrease the microbial virulence, which should prove beneficial for the patient.

Method: In this case study the nature of the biofilm microenvironment was modified by delivering a 1.7% hydrogen peroxide gel, oxygen and Vibramycin into the patient’s periodontal pockets using a direct medication delivery method (Perio Tray, Perio Protect LLC St. Louis, MO.). The hydrogen peroxide (Perio Gel, Perio Protect St. Louis, MO) has specific poloxamer and antimicrobial medicinal effects as it generates 5.7X oxygen concentration when hydrogen peroxide disassociates into water and oxygen within the medical device. The medicinal benefits of hydrogen peroxide, oxygen and Vibramycin help control the biofilm.

Results: The hydrogen peroxide, oxygen and Vibramycin alter the micro-environment of the patient’s periodontal pockets from a more virulent to less virulent population. This decrease in biofilm virulence and a decrease in bacteria numbers is observed clinically as a decrease in bleeding upon probing and pocket probing depth.

Conclusion: Delivering and maintaining hydrogen peroxide, oxygen and Vibramycin in a patient’s periodontal pocket, which alters the biofilm constituency, results in significantly reduced host inflammatory response. The decreased inflammation is observed clinically through decreased bleeding upon probing and decreasing the pocket probing depth of the periodontal pocket.

This case report presents a rare case of an adult female patient of Sturge-Weber Syndrome with unilateral maxillofacial osteohypertrophy. Incidence and exact cause of association of Sturge-Weber Syndrome with osseous hypertrophy is not known and there are very few similar cases that have been reported in literature. Patient visited to the dental department with the chief complaint of malalignment of teeth for which orthodontic treatment plan was done.