Background and purpose: Mouthwashes decrease the risk of VAP by reducing the number of microorganisms and their transmission and colonization in the lung. Among the oral rinses, chlorhexidine is considered as the gold standard but it has a variety of complications. The purpose of this study was to determine and compare anti-bacterial effects of the chlorhexidine gluconate and herbal mouthwashes in intensive care unit patients. Materials and methods: In this double blind randomized clinical trial, 60 patients who were admitted in ICU were divided into two equal 30 persons groups. In the fi rst group Chlorhexidine gluconate 2 % mouthwash and in the second group herbal mouth wash was used. Just before and again after 6 min of oral rinsing, salivary samples were obtained without any stimulation in order to culture Staphylococcus aureus and Streptococcus pneumoniae. The data were processed in SPSS 16 software and were analyzed by appropriate statistical tests. Results: Matrica® and chlorhexidine mouthwashes have signifi cant antibacterial effects against Streptococcus pneumoniae and Staphylococcus aureus. Decreasing of the number of bacteria in samples after oral rinsing was signifi cant in both groups (p < 0.001) but chlorhexidine was signifi cantly more effective than herbal mouth wash in reducing the number of colonies (p < 0.001). Conclusion: The herbal mouth wash has signifi cant antibacterial effects against Staphylococcus aureus and Streptococcus pneumoniae, but its effi cacy is less than chlorhexidine, so after further investigation, it would be considered as an alternative to chlorhexidine in ICUs (Tab. 3, Ref. 33).

The first permanent molar (FPM) plays an essential role in the masticatory function by contributing to the implementation and the maintenance of the occlusion. However, it is considered as the most frequently affected and the earliest affected tooth by caries; 27.4% of the 6-8 years old children have developed at least one cavity on one of the four first permanent molars, according to a study conducted among 3276 school children in Casablanca .Therefore, the FPM should benefit from special vigilance on the part of the practitioner to ensure that any early carious lesion is intercepted. In addition, the FPM, due to its period of mineralization coinciding with early childhood diseases, can erupt with a structural abnormality. Molar incisor hypomineralization (MIH) is considered to be the most common defects observed on first permanent molars among children. A study conducted among 1077 children aged 7-10 years enrolled in schools in Casablanca showed that 7.9% of children were affected with MIH. About 84.7% of the children had the four molars affected. Children with HIM had a significantly higher prevalence of caries: 78.8 versus 33.5%.These structural abnormalities of the enamel must be carried out earlier to ensure that the coronary anatomy is the least compromised.

IntroductionOral diseases may have an impact on quality of children's life. The presence of severe disability requires the use of care under general anesthesia (GA). However, because of the limited number of qualified health personnel, waiting time before intervention can be long. Aim: To evaluate the waiting time before dental care under general anesthesia for children with special needs in Morocco.MethodsA retrospective cohort study was carried out in pediatric dentistry unit of the University Hospital of Casablanca. Data were collected from records of patients seen for the first time between 2006 and 2011. The waiting time was defined as the time between the date of the first consultation and intervention date.Results127 children received dental care under general anesthesia, 57.5% were male and the average age was 9.2 (SD = 3.4). Decay was the most frequent reason for consultation (48%), followed by pain (32%). The average waiting time was 7.6 months (SD = 4.2 months). The average number of acts performed per patient was 13.5.ConclusionWaiting times were long, it is necessary to take measures to reduce delays and improve access to oral health care for this special population.

Treatment of necrotic immature teeth has always been a real challenge for the clinician due to the open apex and weak root structure, which does not allow a conventional endodontic treatment. Several therapeutic options are possible to treat those teeth. Calcium hydroxide apexification is the oldest and most studied therapeutic option, but it has some disadvantages, including the long term of treatment, the possibility of reinfection, and the weakness of the wall. To solve these problems, several authors recommend the revascularization technique. This therapy allows the continuation of root edification with apical closure and thickening of the walls. The aim of our work is to compare the two therapeutic procedures, apexification with calcium hydroxide and revascularization, through a clinical case treated and followed up for 24 months at the pediatric dentistry department in Casablanca, Morocco.

L'actinomycose est une infection spécifique rare, non contagieuse. Elle se localise dans la région des maxillaires, avec une évolution chronique. Le germe le plus souvent incriminé est Maroc. Nous rapportons le cas d'un enfant âgé de 5 ans, qui a présenté des processus suppuratifs chroniques en rapport avec une actinomycose sous mandibulaire gauche. Le diagnostic de certitude a été porté par l'examen histopathologique. Le traitement de cette infection est chirurgical avec drainage et curetage des lésions, associé à une antibiothérapie à forte dose et à durée prolongée. L'actinomycose peut simuler n'importe quelle affection de la sphère ORL, elle peut prendre en particulier un aspect pseudotumoral égarant de ce fait son diagnostic. Une sensibilisation des médecins à cette pathologie s'impose, pour un diagnostic précoce dont dépend le pronostic.