ABSTRACT
The purpose of this study is to focus on the practice of canal irrigation during endodontic treatment in Tunisia through an epidemiological survey among general dentists practicing in private clinics in order to elaborate recommendations and optimize the use of canal irrigation. Materials and methods: Three hundred and fourteen general dentists completed the survey. The data obtained were processed and analyzed by Excel 2007 and SPSS statistics 21.0. Results: The surveyed dentists do canal irrigation during their endodontic treatment. Eighty-nine point two percent of them used sodium hypochlorite at the recommended concentration (between 2.5 and 5.25%).Only 7.9% of practitioners respected the NaOCl dilution and storage rules. Thirty-eight percent used a volume of 10 ml per canal during endodontic treatment. Eighty- six percent used chelator. Thirty-eight percent of surveyed dentist did the last irrigation following the appropriate chronology and only 18.2% used endodontic syringes. Conclusion: The main directions and the criteria of an adequate endodontic irrigation were not respected by most of Tunisian dentists.

ABSTRACT
Aim: This study evaluated the effects of the ultrasonic scaling on the surface roughness of the restorative materials at different power settings. Materials and Methods: 48 specimens of rectangular recesses (12x8x1.5mm) of Teflon molds were made, filled with a nanohybrid composite resin and cured. Pre-ultrasonic surface roughness was measured using Surface Roughness Tester. The specimens were divided randomly into 2 groups with each group consisting of 24 specimens. The group 1 and group2 specimens were subjected under medium and high power setting ultrasonic scaling respectively. Post-ultrasonic surface roughness was measured as mentioned previously. Data were analysed with paired t-test and independent t-test. Results: Statistical analysis was done using SPSS software version 16.0. P <0.05 was considered statistically significant. The results showed that surface roughness of the restorative material increased after ultrasonic instrumentation. Intergroup comparison revealed that post-ultrasonic surface roughness was more in the high power setting when compared to the medium power setting. Conclusion: It is recommended to use medium power setting ultrasonic scaling and to repolish the restorations to bring down the surface roughness to the clinically acceptable level.

ABSTRACT
Systemic lupus erythematosus (SLE) is a chronic multi-system autoimmune disease with very heterogeneous clinical and serological manifestations. SLE is a relatively rare and more frequent disease in women. Clinical criteria such as photosensitivity, malar rash, neurological, articular and visceral manifestations are redefined. Among the immunological criteria, the ANA, anti-dsDNA, anti-Sm and anti-phospholipid antibodies are currently considered. Oral lesions are frequently identified in patients with SLE. They include oral ulceration, discoid lupus, lichenoid lesions, erythematous areas, and leukoplastic plaques. Secondary Sjögren's syndrome may develop. A high prevalence of periodontitis was also detected. Other oral and facial manifestations are reported, such as plaque calcification, joint damage and angioedema.Through our personal case, the role of the oral surgeon seems indisputable in the diagnosis and the management of patients with SLE.

ABSTRACT
Removable orthodontic appliances (ROAs) are popular devices to move or retain teeth during or after orthodontic treatments providing a good environment for adhesion and colonization of pathogenic and non-pathogenic organisms. The aim of the present study was to explore the presence and variability of oral PH, levels of Candida Albicans, Candida Dubliniensis, and Streptococcus (S.Mutans) in children before and during the treatment with ROAs. In this clinical trial study, a total of 160 patients aged 8–12 years old in both genders were enrolled from a larger sample of patients who were clinically confirmed to obtain ROAs. They were randomly divided into three groups; 1- PH Group (n=51), 2- Candida Group (n=51), and 3- S.Mutans Group (n=58). Patients were assessed prior (T0) and again one month later (T1) following appliance insertion. The oral cavity was sampled for PH level, Candida species and bacterial species by culture. Paired t-Test and ANOVA were applied for statistical analysis. The level of significance was assumed to be P ≤ 0.05 for all tests. In Group 1, PH values decreased from 6.89±0.5 in T0 to 6.55±0.7 in T1 (0.5% decrease) with statistically significant difference (P=0.002). In group 2, total Candida count at dorsal tongue was more than hard palate. Also, the difference (5.1±6 increase) was significant between the mean Candida count in T0 and T1 (P=0.001). Although the C.Albicans count was more than C.Dubliniensis, the difference was not significant. In group 3, S.mutans showed a significant difference between the two subgroups of case and control (P<0.005). ROAs change the balance to decrease the values as well as increase the proliferation/colonization of Candida specimen and S.mutans. This implicated the importance of paying special attention to oral hygiene in orthodontic patients to prevent oral disease and the aggravation of systemic disease in immunocompromised conditions.

ABSTRACT
The renewal of removable dentures is often suggested to denture wearers subject to discomfort. However, the impact of this rehabilitation on patients’ oral health related quality of life and their removable dentures related satisfaction is still unknown. This study was aimed at assessing these patient-centered outcomes and the potential impact of different factors. Materials and methods: • In our study, the most appropriate parameters to assess the prosthetic quality have been collected to evaluate the satisfaction perceived by patients about their denture; their complaints and the causes of the refabrication. • A completely new questionnaire has been drawn up including: Reason patients requested new dentures (fit, esthetics, broken denture, wear, recommandations of dentist, extractions), satisfaction with the old prosthesis (general, retention, stability, comfort, pronunciation, chewing, esthetics), and technical quality of the old prosthesis as assessed by a dentist (stability, retention, fit, border, wear, esthetics). • Gender, age and socio-economic status were included as confounding variables • Fifty patients have been included in the survey, they have undergone a clinical examination, and we have filled out the questionnaire anonymously. The Chi2 test, ANOVA test, and Pearson correlation test have been employed to relate clinical and anamnestic factors to the causes of removable denture renewal.

ABSTRACT
The fracture of endodontic instruments is an unpleasant occurrence that may hinder the endodontic therapy with an impact on the prognosis of the treatment. Therefore, an attempt to remove the broken file should be considered in most cases. Various techniques and modalities have been developed to facilitate the removal of the separated fragment. The orthograde method and by- pass technique are two recommended approaches with a successful outcome when managed properly. Several factors have to be considered before choosing to remove a fractured instrument. The chances of success have to overweigh the possible complications. The purpose of this article was to describe through clinical cases, the management of separated endodontic instruments with orthograde method and non-invasive technique.

ABSTRACT
Marfan syndrome (MIM 154700) is a variable, autosomal dominant disorder of connective tissue whose cardinal features affect the cardiovascular system, eyes and skeleton. The diagnosis of Marfan syndrome (MFS) relies on defined clinical criteria (Ghent nosology), outlined by international expert opinion to facilitate accurate recognition of this genetic aneurysm syndrome. The patient with MFS has multiple oral decrease that may be diagnosed and treated on time to increase the life quality of the patient. Treatment planning is related to the age of the patient, the type and severity of the disorder, and the oral health of the patient. AIM: The aim of this article was to describe through two cases the orofacial manifestations of Marfan syndrome and to demonstrate the role of the pediatric dentist in the early diagnosis of this genetic defect from the oral pathognomonic signs of this syndrome and and the therapeutic management of those children.

ABSTRACT
According to the World Health Organization, maxillo-mandibular odontogenic myxoma is a benign tumor of mesenchymal origin. Its frequency, rare etiology, pathogenesis and therapeutic modalities are often discussed in the literature. It is a rare tumor that accounts for 0.41% to 7.19% of maxillo-mandibular tumors. In this present study, we reported a case of odontogenic myxoma of the left jaw that had progressed for several years, in a 25-year-old patient referred to the odontostomatology department of the Idrissa Pouye General Hospital by his attending dentist. The onset of symptoms went back three years. The volume of the mass evolved gradually and slowly over time. The medical examination did not reveal any particular medico-surgical history, or associated general signs. The intraoral examination revealed on inspection a tumor mass occupying the vestibular premolo-molar region of the left maxilla and measuring approximately five centimeters along its longest axis. This mass was bumpy in shape and reddish in color in places. On palpation, the mass was painless, mobile, of firm consistency, not bleeding on contact. Maxillofacial computed tomography revealed the presence of a spontaneously isodense, budding osteolytic process with lobulated contours, blowing the left maxilla in its anterior part. It extended into the hallway and made contact with the inside of the cheek, but did not invade it. The therapy was surgical under general anesthesia. No recurrence was observed at 9 months later. Maxillo-mandibular odontogenic myxoma is a rare, benign and locally invasive tumor. Its odontogenic origin remains the most likely. The clinical aspects or the radiographic presentation are not characteristic and make the differential interpretation difficult. A biopsy is mandatory for the establishment of a final diagnosis. The treatment is surgical. Rigorous monitoring is required during the first two postoperative years, as recurrences are not uncommon.

ABSTRACT
Short clinical crowns result in poor retention form and thereby leads to improper tooth preparation and ultimately failure of restoration. The purpose of this case report was performing patient customized site specific surgical crown lengthening of grossly decayed tooth structure in left mandibular 2nd premolar area. The tooth was root canal treated with width of keratinized gingiva about 2mm on buccal side, with fibrotic gingival enlargement on interdental area and lingually. Apically displaced flap on buccal side with osseous resection of 3mm and undisplaced flap on interdental and lingual side with osseous resection of 3mm was done. Optimal clinical crown length was achieved and was maintained at 3months and 6 months follow up.