Pattern of Demand for Removable Acrylic Partial Denture (RPD) in the city of Port Harcourt, Nigeria

Background: Pattern of demand for RPDs and distribution of stock teeth carried by these prostheses is rarely reported. The current study is designed to determine the pattern of demand for RPDs and to compare the patterns of distribution of stock teeth carried by these prostheses between the right and left sides of each jaw and between the upper and lower jaws respectively.Materials and Methods: This retrospective study reviewed the authorization forms of 1,000 adult patients who requested for RPD from two dental hospitals in the metropolitan city of Port Harcourt, Nigeria. The gender, type (upper, lower or both) of RPD and the teeth requested were analyzedResults: There were 906 properly filled forms belonging to 464 (51.2%) females and 442 (48.8) males. More males (38.5%) compared to 32.5% females requested for upper RPD and more females (15.8%) as against 7.3% males demanded for lower RPD. More males (3.5%) compared to females (3.0%) requested for combination of upper and lower RPD. A decline in the number of teeth demanded was noted as we move away from the central incisor to the nd 2nd premolars. No marked difference was noted between the distribution of teeth provided for the right and left sides of each jaw. More prosthetic teeth were demanded for the upper jaw.Conclusion: More females requested for removable acrylic partial denture. No marked difference was noted  between the distribution of teeth provided for the right and left sides of each jaw. More prosthetic teeth were demanded for the upper jawKey words: Acrylic partial denture, removable, stock teet

Ozone therapy and restorative dentistry: a literature review

Objective: Over the recent years, restorative dentistry has shifted towards practicing preventive dentistry and adopting more conservative and tooth-preserving procedures. This approach is being further reinforced with the emergence of ozone therapy in the management of tooth decay. Ozone therapy is the treatment of the tooth with a mixture of oxygen and ozone. The aim of this review was to provide a comprehensive literature on ozone therapy and on the different areas of restorative dental specialty where this emerging treatment alternative has been found applicable.Method: The Medline and Google databases were searched for relevant literature using the following terms “ozone therapy and dentistry”, “ozone”, “atraumatic tooth restoration”, “tooth decay and remineralization”. Manual library search and review of bibliographies of published literature were also conducted. Publications that discussed what ozone therapy is all about, thehistory, mechanism of action, production of ozone, toxicity and clinical applications particularly in Restorative Dentistry were extracted.Result: Ozone therapy causes remineralization of incipient pit and fissure caries as well as incipient root caries. Its usefulness in open lesions has also being demonstrated. Dental decay may sometimes be managed without the conventional anaesthetic, drill and filling. It is also used in Restorative Dentistry for sterilization of removable dentures and avulsed tooth, tooth bleaching and desensitization. There is conflicting evidence regarding its application in endodontics at the moment.Conclusion: There is some demonstrable emerging evidence to suggest that ozone therapy is useful in restorative dentistry and it could turn around for good the practice of the discipline in the near future. Its mode of application in dentistry ensures its safety.Key words: Ozone therapy, caries, remineralization, atraumatic restoratio

Patient-Reported Outcomes of Metal and Acrylic Resin Removable Partial Dentures : A Systematic Review and Meta-Analysis

Metal removable partial dentures (RPDs) are often considered long-term treatment options for partially edentulous patients, while acrylic resin RPDs are considered interim treatments. The aim of this review was to compare metal and acrylic resin RPDs regarding patient-reported outcomes for partially edentulous individuals. Four databases (MEDLINE, EMBASE, CENTRAL, and Web of Science) were systematically searched for observational studies and randomized controlled trials comparing patient-reported outcomes between metal and acrylic resin RPDs. The primary outcome was patient satisfaction. Included studies were assessed for risk of bias using the Cochrane risk of bias in nonrandomized studies of interventions tool (ROBINS-I) and the Cochrane Collaboration Risk of Bias Tool for Randomized Controlled Trials. The level of evidence was evaluated using Oxford Center for Evidence-based Medicine tool. A random-effects model was used to analyze the data. A total of 15 studies were included in the systematic review; 10 in the meta-analysis. The pooled effect size for patient satisfaction and oral health-related quality of life showed no statistical significant difference between metal and acrylic resin dentures (0.22, 95% confidence interval -0.01, 0.45, p = 0.06; 1.45, 95% confidence interval -2.43, 5.33, p = 0.46, respectively). Compliance with using RPDs was significantly higher in patients with metal compared to patients with acrylic resin dentures (pooled odds ratio = 0.57, 95% confidence interval 0.45, 0.73, p < 0.001). Most studies had critical to serious risk of bias and low level of evidence. The reviewed studies showed that there was no significant difference between metal and acrylic resin RPDs in patient satisfaction and oral health-related quality of life. Metal dentures were associated with higher patient compliance rates and were preferred more by patients compared to acrylic resin dentures. However, the reviewed studies had low levels of evidence and therefore, high-quality randomized controlled trials are needed to conclusively address the question of this review

Porphyromonas gingivalis gingipains cause defective macrophage migration towards apoptotic cells and inhibit phagocytosis of primary apoptotic neutrophils:gingipains, apoptotic cell removal & inflammation

Periodontal disease is a prevalent chronic inflammatory condition characterised by an aberrant host response to a pathogenic plaque biofilm resulting in local tissue damage and frustrated healing that can result in tooth loss. Cysteine proteases (gingipains) from the key periodontal pathogen Porphyromonas gingivalis have been implicated in periodontal disease pathogenesis by inhibiting inflammation resolution and are linked with systemic chronic inflammatory conditions such as rheumatoid arthritis. Efficient clearance of apoptotic cells is essential for the resolution of inflammation and tissue restoration. Here we sought to characterise the innate immune clearance of apoptotic cells and its modulation by gingipains. We examined the capacity of gingipain-treated macrophages to migrate towards and phagocytose apoptotic cells. Lysine gingipain treatment of macrophages impaired macrophage migration towards apoptotic neutrophils. Furthermore, lysine gingipain treatment reduced surface expression levels of CD14, a key macrophage receptor for apoptotic cells, which resulted in reduced macrophage interactions with apoptotic cells. Additionally, whilst apoptotic cells and their derived secretome were shown to inhibit TNF-α induced expression by P.gingivalis LPS, we demonstrated that gingipain preparations induced a rapid inflammatory response in macrophages that was resistant to the anti-inflammatory effects of apoptotic cells or their secretome. Taken together these data indicate that P.gingivalis may promote the chronic inflammation seen in periodontal disease patients by multiple mechanisms including rapid, potent gingipain-mediated inflammation coupled with receptor cleavage leading to defective clearance of apoptotic cells and reduced anti-inflammatory responses. Thus gingipains represent a potential therapeutic target for intervention in the management of chronic periodontal disease

Bilaterally Impacted Supplemental Premolar: A Case Report and Review of the Literature

Background: It has been described as interesting to encounter supplemental teeth, as the condition rarely occurs. The purpose of this report is to add to the scanty literature on the subject of supplemental teeth and to emphasize the significance of full-mouth radiograph for every patient at the initial dental consultation. Method: A case of an 18 year old young lady with incidental finding of bilaterally impacted supplemental premolar is presented together with a review of the literature Result: The patient presented with a recurrent history of toothache and palatal swelling of 1 year duration in relation to a slightly discoloured upper left central incisor. Examination revealed an incidental finding of bilaterally impacted supplemental premolar causing pressure effect on adjacent teeth. Conclusion: A full mouth clinical and radiological examination of every patient presenting at the dental clinic for the first time should not be taken for granted. Keywords: Supernumerary teeth, supplemental teeth, impacted premolar Nigerian Journal of Medicine Vol. 17 (3) 2008: pp. 363-36

Prevalence of dental caries among adult patients attending a tertiary dental institution in South-South region of Nigeria

Background: Oral health is an important component of the general health and dental caries status of a community is a good indicator of oral health status of that community. Epidemiological studies on dental caries are rare in the Niger Delta region of Nigeria.Aim: To determine the prevalence of dental caries among adult patients attending University of Port Harcourt Teaching Hospital Dental centre and to compare it with previously reported results.Methods: A cross-sectional study of all patients aged 18years and above presenting with dental caries at the centre over a one-year period was conducted. A self-administered anonymous questionnaire was used to get the socio-demographic data of the patients. The patients were all examined and caries was diagnosed using the WHO criteria (1997). Decay, missing and filled teeth (DMFT) were recorded and restorative index was calculated (F/F+D percent). SPSS version 15 was used to generate summary statistics and student t-test was used to compare means between two groups.&nbsp;Results: Out of 1,927 patients that presented during the study period, only 435 had dental caries or one of its sequelae giving a prevalence of 22.6%. The mean DMFT score for the group was 3.57; that of females was 3.88 while that for males was 3.08. The difference in the mean DMFT scores between the two sexes was statistically significant (p=0.026). The restorative index was 25.3%.Conclusion: The prevalence of dental caries in our centre (22.6%) falls within the previously reported 4-30% rates for Nigeria. The mean DMFT score was 3.51 and the restorative index is 25.3%. Keywords: Prevalence, Caries, Adults, South-South regio

Barriers to oral health care utilization in Ibadan, South West Nigeria

Background: Barriers to oral health utilization are many, but those that are significant for our environment are not yet clear. The current study was designed to identify and graduate the barriers to receipt of oral health care among a cross-section of patients attending our centre. We also investigated the influence of socio demographic factors on the highly rated barriers. Methods: This cross-sectional study was conducted among patients visiting UCH, Ibadan using a self-administered questionnaire. Socio-demographic variables and oral health care seeking behaviour were requested and in addition, the respondents were asked to rank 11 listed barriers to receipt of oral health care and any other barriers they may think of in order of strength. Factor analysis was employed in order to identify four factors with the highest loading. The mean scores were compared using t-test and one-way ANOVA and the level of significance was set at 0.05 Results: Only 400 questionnaires were properly filled (84.9%) out of the 471 that were administered. The mean age of these participants was 37.85±15.38 years. Most of the respondents (55.8%) consulted the dentists only when there was pain while 109(27.3%) had never visited the dentist. Fear of dental injection, cost of treatment, feeling of insecurity when the dentist is operating and disturbing noise from dental drill were the major barriers. There was a statistically significant association between age groups and feeling of insecurity (p=006). Conclusion: The major barriers to oral health care utilization among our patients were fear related

A case of quackery and obsession for diastema resulting in avoidable endodontic therapy

Background: Perception of midline diastema differs among individuals and cultures. To some, it is a feature of beauty, while to others it is aesthetically appalling. From a scientific point of view, midline diastema is a deviation from normal adult dentition. It is not uncommon among some African natives to find individuals demanding for artificially created midline diastema from dental practitioners. Objective: To present a rare case of pulpal necrosis involving maxillary and mandibular central incisors as a result of poorly executed teeth modification in a bid to create upper and lower midline diastemata. Result: A 23-year old lady presented with history of spontaneous, sharp, persistent pain associated with palatal swelling and discharging sinus of two weeks duration in relation to maxillary central incisors (11, 21). The complaint was preceded by a history of recurrent pain in relation to 11, 21, 31 and 41 which started soon after obtaining artificially created maxillary and mandibular midline diastemata from a dental quack. Periapical x-ray revealed periapical radiolucency in relation to 21 and 41. Vitality test confirmed necrotic pulp in the lower central incisors. The affected teeth were scheduled for root canal therapy (RCT) and porcelain fused to metal crown. The RCT of 11 and 21 had been completed but further treatment stalled due to financial constraint. Conclusion: This is a case of obsession for midline diastema, poor dental health education, and illegal dental practice

Knowledge of Medical House Officers about Dental Specialties

Background: Some patients with oral diseases present initially to a general medical practitioner who is expected to refer the patients to the appropriate dental specialist for management. Thus they are expected to have a good knowledge of the different specialties in dentistry. This study was designed to determine the knowledge of medical house officers about the specialties in dentistry and how this will influence their ability to make appropriate referral. Methods: Two hundred structured questionnaires were distributed to medical house officers in six teaching hospitals in Nigeria. The questionnaire items include: age, sex, university attended, extent of dental education received and the knowledge of oral diseases. Responses were scored and transferred to a micro&shy;computer and analyzed with SPSS. Results: Response rate was 146 (73.0%), 83 respondents (56.8%) had exposure to dentistry, while 64 (43.2%) did not. Majority of the respondents scored below 39.0%. When the responses were analyzed, the best performance was in the identification of oral diseases managed by the oral and maxillofacial surgeon (31.7%). The worst performance was recorded in the area of preventive dentistry (9.0%). The proportion of those who scored 50% and above was more among those who were exposured to dentistry. Conclusion: The knowledge of medical house officer about oral diseases and the specialties that manage such diseases was poor. Exposure to dental education appears to have some benefit. Keywords: Knowledge, Medical house officers, Dental specialties