The efficacy of R-Endo rotary NiTi and stainless-steel hand instruments to remove gutta-percha and Resilon.

International audienceAIM: To evaluate the efficacy of the R-Endo rotary nickel titanium instrumentation system and hand instrumentation to remove gutta-percha or Resilon from root canals. METHODOLOGY: Eighty single-rooted teeth with straight canals were selected, the pulp chamber was opened, and the canals prepared to a size 30, 0.04 taper. The teeth were divided randomly into two groups of 40 each for root filling with gutta-percha + MMSeal sealer or Resilon + RealSeal sealer. After storage, each group was divided into two subgroups, and material was removed with Hedström files or with R-Endo instrumentation. Times to reach the working length and to eliminate filling material were recorded. Root canal walls were examined using scanning electron microscope to evaluate material remnants on each third. The presence of material was measured according to a score scale. The Student's t-test was used to determine significant differences between mean values of time and remaining material (P 0.05). However, times to reach the working length and for removal of filling were lower with R-Endo than with Hedström files (P < 0.0001). CONCLUSIONS: Both instrumentation techniques left filling material inside the root canal and mainly in the apical third. There was no difference between the instrumentation techniques

Evaluation of the oral health of pregnant women in prenatal consultations in Côte d’Ivoire

Abstract Background Despite the proven links between oral health status and adverse pregnancy outcomes, oral examination is not systematically integrated into prenatal examinations in Côte d’Ivoire. In addition, there are no prevention messages specifically targeted at pregnant women. Objective: To assess the oral health of pregnant women in Côte d’Ivoire. Methods A cross-sectional survey was conducted at the Maternal and Child Health Department of the National Public Health Institute in Abidjan. The data collected were: age, education level, marital status, source of income, trimester of pregnancy, gestational age, oral hygiene habits and the fact that they whether or not received oral health information. A clinical examination was conducted to assess oral hygiene (OHIS index), periodontal condition (CPI index), dental condition (DMFT index), as well as the presence of epulis, erosion or dental mobility. Frequencies and counts were calculated for the different variables in the study. Results A total of 207 women were observed. The age range was 15 to 44 years with 14.0% under 19 years old. The majority were in couple (76.8%), multi-gesture (77.3%), and more than half had no education (52.2%) or source of income (56.0%); 50.7% snacked between meals and 33.3% had vomiting. They brushed their teeth at least twice a day (70.0%) and had not changed their oral hygiene habits (77.3%) during this pregnancy. Only 3.4% had information on oral health conditions during pregnancy. The frequency of caries was 75.4%, dental erosions 13.0%, gingivitis 57.0%, periodontitis 6.8% and epulis 3.4%. Conclusions The results suggest the integration of systematic dental consultation into prenatal consultations in order permit the sensitization of these women, screening and management of their oral conditions. Key messages Oral diseases of pregnant women are a reality without their knowledge in Côte d’Ivoire. A systematic dental visit is essential during prenatal consultations in Côte d’Ivoire. </jats:sec

Discrimination of people living with hiv/aids: a survey with dentists in Abidjan, Côte d’Ivoire

Abstract Background Despite several decades of fighting HIV infection, discrimination against people living with this infection persists, even among health professionals. Understanding the determinants of discriminatory attitudes of dentists is a first step towards access to oral health care and improved care for people living with HIV (PLHIV). Objectives To analyse the determinants of discriminatory attitudes towards people living with HIV among dentists in Côte d’Ivoire. Methods A cross-sectional survey was conducted among dentists in Abidjan in 2016. In addition to socio-professional characteristics, a questionnaire collected information on their knowledge about HIV (transmission, hiv-related oral diseases) and their individual perception (fear of being contaminated, cross-contamination...). The chi2 test for independent sampling was used to identify factors associated with discriminatory attitudes (threshold α = 5%). Results A total of 120 dentists were interviewed: 61.3% from the public sector; 56.7% men; 54.2% in couple; 53.3% had participated in continuing education on HIV; 29.2% did not know HIV-related diseases and transmission modes and 69.2% reported fear of being infected during care; 44.2% reported informing staff of the patient’s HIV status. The proportion of dentists with discriminatory attitudes was estimated at 69.2%. The main associated factors were: female gender (p = 0.001), living in couple (p = 0.000), lack of knowledge of the risk of HIV transmission after a blood exposure accident (p = 0.000), the law protecting people living with HIV in Côte d’Ivoire (p = 0.009) and fear of being infected (p = 0.000). Conclusions The results of this study show that the determinants of discriminatory attitudes among dentists result from their lack of knowledge of the disease, justifying the need to strengthen their continuing education on HIV/AIDS infection. Key messages Dentists discrimination towards people living with HIV infection result from their lack of knowledge about the infection. It’s essential to strengthen their knowledge about HIV in order to improve access to care for people living with HIV. </jats:sec

Accessibility to oral health care of precarious and non precarious populations in Côte d’Ivoire

Abstract Introduction The purpose of any health system is to guarantee access to care for the entire population served. However, the socio-economic insecurity situation of people in precarious situations, raises the problem of their access to oral health care considered to be expensive. The objective of this study was to compare the dental status and modalities of oral health care use by people in precarious situations to group of non-precarious population in Abidjan, in Côte d’Ivoire. Methods The cross-sectional study was conducted at the University Hospital Center of Treichville. It concerned all users of the dental office of this hospital. Subjects in precarious situations were identified using a screening tool. Was considered to be in a precarious situation, a person living with less than 1.5 USD/day, having no fixed address, looking for a job, having no health insurance or having difficulties in dealing with medical and pharmaceutical costs. We have identified variables for the modalities of oral health care use and follow-up. The frequencies of these variables were calculated and comparisons were made between subjects in precarious and non- precarious situations using the Chi2 test. Results 256 people participated in the study. The tool for identifying precariousness made it possible to distinguish 128 subjects classified in precarious situations and 128 others in non- precarious situations. The number of missing teeth in people in precarious situations was twice as high as in non-precarious subjects. Renunciation of dental care was more common in the precarious group (46%) than in the non- precarious group (32%). Absenteeism rates at the first two appointments were higher among the precarious (54%) than among the not precarious (46%). Conclusions These results show the need to sensitize the population on the importance of oral health and the establishment of social protection mechanisms to ensure greater accessibility to care for people in precarious situations. Key messages Improving the oral health of populations, especially vulnerable population groups, requires the establishment of social protection mechanisms to remove the financial barrier to access to care. Educating the public about the importance of oral health for overall good health is essential to improving the use of dental care. </jats:sec

Causes of false-positive HIV rapid diagnostic test results

HIV rapid diagnostic tests have enabled widespread implementation of HIV programs in resource-limited settings. If the tests used in the diagnostic algorithm are susceptible to the same cause for false positivity, a false-positive diagnosis may result in devastating consequences. In resource-limited settings, the lack of routine confirmatory testing, compounded by incorrect interpretation of weak positive test lines and use of tie-breaker algorithms, can leave a false-positive diagnosis undetected. We propose that heightened CD5+ and early B-lymphocyte response polyclonal cross-reactivity are a major cause of HIV false positivity in certain settings; thus, test performance may vary significantly in different geographical areas and populations. There is an urgent need for policy makers to recognize that HIV rapid diagnostic tests are screening tests and mandate confirmatory testing before reporting an HIV-positive result. In addition, weak positive results should not be recognized as valid except in the screening of blood donors