Evaluation of post-operative sensitivity and secondary caries in posterior composite restorations: A 12month study

To evaluate post-operative sensitivity and secondary caries associated with posterior composite restoration. The study involved restoration of occlusal and proximo-occlusal caries on premolars and molars of 62 patients seen at the out-patient clinic of the restorative department of the Lagos University Teaching Hospital. The restorations were completed with a micro-hybrid light curing resin composite (Unolux BCS, UnoDent, England). Following total etch procedure and use of a type 2 (5 generation/one-bottle) adhesive. The USPHSC or modified Ryge criteria was employed for direct evaluation of the restorations over the 12 month period.Post-operative sensitivity was 3.5% Bravo at baseline and 1.7% Bravo at 12 months. No significant change in result was recorded for post-operative sensitivity at the end of the evaluation period. 100% was recorded for the absence of secondary caries throughout the evaluation period up till the 6 month when a failed restoration scored 1.7% Bravo.At 12 monthsAlpha scores for secondary caries was 98.3%. Post-operative sensitivity was kept to a minimum and there were no occurrences of secondary caries

Single visit root canal treatment: A prospective study

Objectives: The aim was to determine the success rate of single visit root canal treatment (RCT) and thus encourage clinicians to offer this treatment option appropriately.Materials and Methods: This was a longitudinal clinical study involving all teeth of the secondary dentition except third molars in the upper and lower jaws. Teeth having irreversible pulpitis, pulp necrosis or periapical periodontitis were included in the study. RCT and obturation was done at a single visit. The patients were monitored over 6 months.Results: Forty.five teeth were treated in 21 females and 24 males, aged 18.56 years (34.4+/.12.7). Preoperatively, pain was present in 84.4%, tenderness to percussion in 53.3%, and periapical radiolucency in 24.4% teeth. Forty percent had irreversible pulpitis and 60% had apical  periodontitis. Post.operatively, pain reduced to 51.1% on day 1, 15.5% at 1 week, and 0% for the rest of the period. Tenderness to percussion reduced to 15.6% at 1 week and 0% by 1 month. Periapical radiolucency reduced to 9.5% at 6 months. Favorable outcome of 33.3% was recorded on day 1 and increased to 90.5% at 6 months. Six months success rate for teeth which had irreversible pulpitis was 100% and 83.3% for apical  periodontitis. The mean time needed to complete a single visit RCT ranged from 77 min for a tooth having one canal to 132 min for one having four canals.Conclusion: Single visit RCT is a viable treatment option for teeth having irreversible pulpitis or apical periodontitis irrespective of tooth type or number of canals. Clinical Significance: A lot of patients are lost to  follow.up visits for teeth requiring RCT once the pulp is extirpated at the first visit due to cessation of pain, subsequently leading to treatment failure. Single visit endodontics eliminates the need for follow.up visits and improves treatment prognosis.Key words: Pain, periapical radiolucency, single.visit endodontics, tendernes

Evaluation of the mechanical and physical properties of a posterior resin composite in posterior adult teeth

To evaluate the mechanical and physical properties of a micro-hybrid resin composite used in adult posterior restorations A micro-hybrid, light curing resin composite Unolux BCS Composite Restorative, (UnoDent, England) was used to restore 74 carious classes I and II cavities on posterior teeth of 62 adult patients. The restorations were evaluated immediately following placement (Baseline), at 1 week, 3months, 6months and12months using the United States Public Health Service Criteria/Modified Ryge criteria for direct evaluation. Color matching, marginal stains and adaptation, wear and surface texture were evaluated. Ranging from best tothe worst, the ratings were,Alfa, Bravo and Charlie. 58 restorations were available for review at the 12 month evaluation, 15 patients bearing 21.6% of the restorations were lost to recall. Colour match scores were 89.6% Alpha at baseline and 74.1% at 12-month review. Marginal staining were 100%Alpha at baseline and 98.3%Alpha at the end of the evaluation period. Marginal adaptation at baseline was 100%Alpha this value dropped to 94.8% by the 12 month.Anatomical wear scores were 100%Alpha at baseline and scores dropped to 93.1% at the 12-month evaluation.At baseline,Alpha scores for Surface texture were 100%.Adrop inAlpha scores to 93.1% at the first week review was maintained till the 12 month.Carefully controlled placement of micro-hybrid resin composite using the total etch and type 2 (one-bottle ) adhesive can produce satisfactory posterior restorations on permanent teeth

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

Root form and clinical radiographic estimation of the number of root canals in maxillary first and second premolars among Nigerians

The objectives of this study are to document the root form and the clinical radiographic estimation of the number of root canals in maxillary first and second premolars. The root form of 100 extracted maxillary premolars, the pre-operative radiographic estimation and clinical radiographic determination of the number of root canals in 340 maxillary premolars of Nigerian patients attending the dental hospital for endodontic treatment were studied. The maxillary second premolars had one root in 60% and two roots in 34% of cases. 18.4% had one canal (Vertucci type I). 35.3% had two canals with one apical foramen (Vertucci type II), while 46.3% had two canals with separate apical foramina (Vertucci type IV). Result of the correlation of the pre-operative radiographic impression with clinical findings indicates a significant positive relationship (maxillary second premolars r = 0.07307, p < 0.001). In Nigerians, the maxillary second premolar may be single rooted but most of the time it has two canals. Keywords: root form, radiographic, root canals Nigerian Medical Practitioner Vol. 49(4) 2006: 68-7

Diagnosis of Pulpal Pain by Dentists in Nigeria

Pain is the commonest reason why patients seek dental help. Majority of the pain are of pulpal origin. Accurate diagnosis of pulpal pain requires good dental history taking, clinical examination and use of diagnostic tests or tools. This study was designed to assess the parameters used by dentists in Nigeria to arrive at a diagnosis when a patient presents with pulpal pain. A self administered questionnaire was given to all dentists attending the basic and clinical update courses of the Faculty of Dentistry, National Postgraduate Medical College of Nigeria and The West African College of Surgeons over a period of two years. One hundred and seven dentists completed the questionnaires, comprising of forty-eight (44.9%) male and fifty-nine (55.1%) female respondents. Dental X-ray machines were available in 106 (99.1%) practices while, 36 (33.6%) and 11 (10.3%) had access to electric pulp tester and ethyl chloride spray respectively. Eighty-eight (82.2%) and 104 (97.2%) dentists respectively, always used radiographs and percussion tests in making a diagnosis. Hot or cold thermal sensitivity test was sometimes used by 26 (24.2%) and 17 (15.9%) dentists. 10 (9.3%) of them considered clinical history as a diagnostic criterion. Accurate diagnosis of reversible and irreversible pulpitis was made by 88 (82.2%) and 89 (83.2%) of the study group when given a clinical model. It was concluded that diagnosis of pulpal pain was usually made using radiographs and percussion test, while thermal sensitivity test and clinical history were not frequently used. KEY WORDS: Diagnosis, pulpitis, pain. Nigerian Journal of Health and Biomedical Sciences Vol.4(1) 2005: 53-5

Treatment and failure of amalgam restoration analyzed according to class of restoration

Aims: This is a cross sectional; longitudinal retrospective study to find our reasons for placement of amalgam restoration at a Teaching Hospital in Nigeria and the most common classes of amalgam cavity prepared for amalgam restoration.Material &amp; methods: The record of patients also offended the dental centre of hospital in Nigeria was used for this study and all II records were centralized to separate those that attended the Conservation Dental Clinic for placement were recalled for a cross-examination and comparison with the records.Results: Out of the 431 patients recalled, two hundred and seventy seven turned up (64.3%).&nbsp;Two thousand and ninety four restoration were placed in regular attendees with classes I,II &amp; V Accounting for 60.08%, 36.77% and 3.16% of all restorations placed respectively, primary caries accounted for 74.1% of all restoration placed, fractured restoration 16.1 % defective margins 3.7%; secondary caries 2.8% dislodged restoration 1.2 %;overcharging amalgam restoration 0.4% cervical abrasion 1.3 % and other reasons which include attrition, iatrogenic preparation accounted for 0.3%.The reasons given for failure in the pooled study was seen repeating itself in that order in Class I and II.Discussion: Class I restorations was the most commonly placed restoration followed by class II and class V restoration, the most common cause of failure in this study in all the classes of restoration was fractured amalgam restoration and the percentage is much higher for class II restorations. This may be due to the high masticatory load it is subjected to as a result of the cultural diet effect practiced in this environment, whereas in other studies carried out in the Caucasian region and other developed economies, secondary caries form the major reason for placement of restoration.Clinical significance: Amalgam fillings are the most commonly performed restoration when treating caries but data in the developing countries on amalgam is sparse and dearth. It is of importance to know the longevity, the failure pattern, shortcoming of the restoration and to find out if the dates in developed countries tally with developing world for analysis and comparison.Conclusion: Dietary habit may be a major reason in failure of amalgam restoration and it is important to note that cultural background may be a deciding factor in the types of failure seen.The problem of over diagnosis of carious lesion may also play a part in primary caries especially in the Teaching Hospital/Dental College unlike what is seen in General Dental centres or Hospital, because Dental students and resident doctors in training are involved in the clerking and treatment of patients.</p

A self-assessment pilot study of facial aesthetics following prosthetic obturation in patients with surgically acquired partial maxillary defect

br>Background: Improved and satisfactory facial aesthetics following prosthetic obturation of surgically acquired partial maxillary defect had been reported in several case reports involving one patient or two, but this number is grossly inadequate for a reliable deduction. Besides, literature is scarce on the relationship between facial aesthetics and the “class of surgical defect”. Surgically acquired partial maxillary defect has earlier been classified into classes I to VI. Aims: To assess the perception of patients regarding their facial aesthetics following prosthetic obturation and to relate this finding to their classes of surgical defects. Methods: This prospective study was conducted in a tertiary dental centre, University College Hospital, Ibadan. Consecutive patients who had maxillary resection resulting in partial maxillary defect seen over a period of two years were admitted to the study. The facial assessment was done using the technique described by Lang and the result is rated as: Excellent; Very good; Good; Fair; Poor. Results: There were 12 patients aged between 18 and 60 years who had maxillary resection resulting in partial maxillary defect. Eight patients (66.7%) recorded excellent facial appearance, three (25%) recorded a very good appearance while the remaining one patient had a fair result. Out of those who recorded excellent results, five had class I surgical defect, two had class II and the remaining one had class VI. Conclusion: The majority of the patients were, at least, very satisfied with their facial aesthetics. The class of the surgical defect appeared to affect the resultant facial appearance perception. Port Harcourt Medical Journal Vol. 1(1) September 2006: 9-1

Coronal tissue loss of endodontically treated permanent teeth of patients seen in a Nigerian Teaching Hospital

Objectives: The study was done to determine the extent of coronal tissue loss of endodontically treated teeth. Results: 176 teeth of 168 patients that completed endodontic treatment to obturation stage were evaluated for coronal tissue loss. The teeth included fifty-five anterior teeth (31.3%), seventy-three premolars (41.5%) and forty-eight molars (27.3%). Majority (43.2%) of the root filled teeth evaluated for coronal damage had minimal coronal tissue damage, followed by teeth with significant tissue damage (33.5%), and lastly, teeth with moderate tissue damage (23.3%). Conclusions: The result of this study revealed that most endodontically treated teeth had minimal coronal tissue loss and therefore can be managed with conservative restorative treatment options. Keywords: coronal tissue loss, endodontically treated teeth Nigerian Journal of Health and Biomedical Sciences Vol. 5(1) 2006: 72-7

Distribution and Characteristics of Non Carious Cervical lesions in an Adult Nigerian Population

Background: Controversies rages in the literature as to the characteristics of non carious cervical lesions (NCCLs) in terms of the location and its severity.Objective: The study is to investigate the characteristics of NCCLs in adult patients who had a high incidence in them and to see if there are any association with the findings.Methods : The author examined 356 teeth with NCCLs in 34 subjects ( male and female aged 22-75 years). The characteristics were based on the location of the lesion and the size (shape, extensiveness and depth).Results : In terms of the location, 61.2% were located on the posterior teeth, and 55.9% on the maxillary teeth. The first premolars (25.8%) and canines (19.4%) were affected most often, followed by the first molars (16.9%) and second premolars (13.8%). There was slight right side preponderance (50.3%) and more lesions in the male subjects (67.4%). Patients tended to be older, with 76.4% in the 40years and older age group. In terms of the size of the lesion, 75.0% of the lesion had angular shape of &lt;135 (wedge), 70.2% had axial depth of 1-2mm, and 51.7% had occlusogingival width (extensiveness) of 2-3.9mm (small). There was association between gender and the severity (extensiveness) of the lesion. The severity (shape and extensiveness) of NCCL was associated with age. There was strong association between the severity of NCCL and site of the lesion (jaws).Conclusion: The authors found that NCCLs were significantly related to age. The posterior maxillary teeth especially the first premolars followed by the canines were the teeth commonly involved. No great difference in incidence was found between the right and left sides as a result of right or left hand dexterity. Awareness of a multifactorial etiology in noncarious cervical lesions may help the clinician to formulate an appropriate treatment plan for the patient. In addition, these characteristics help identify which teeth and patients that are more susceptible.Key Words: Distribution, Characteristics, Noncarious Cervical Lesion, Adult Nigeria