COMPARATIVE STUDY OF TREATMENT OUTCOME IN APICECTOMIES WITH OR WITHOUT ROOT-END FILLING.

BACKGROUND: High success rate has been reported widely with conventional endodontic. When failure occurs, re-treatment alone or with surgical endodontics is the recommended treatment. OBJECTIVE: To compare the treatment outcome following apicectomy techniques, apicectomy with and without retrograde root - end filling. METHODOS: Fifty three patients presenting with clinical and radiological evidence of pulpal and periapical pathology ≥5mm that will require apicectomy were randomly recruited into the study groups A or B over a period of 12 month. In group A apicectomy was performed without root - end filling and in group B apicectomy was performed with root - end filling. Patients were recalled 12 months and assessed clinically and radiologically. RESULTS: 35 out of 53 recruited patients reported for 12 month re-call visit. Two were excluded because of missing baseline radiographs. 33 patients that reported at 12months recall visit with complete radiographs were used for analysis. Patients age ranged from 16 - 66 years, with those in age group 21 - 30 years predominant, Majority (57.6%) were males. Forty teeth were treated, 14 had root - end filling and 26 without root - end filling. Maxillary incisors were the most frequently apicectomized teeth. 32 (80%) out of 40 apicectomized teeth were successful, 14 (88.5%) out of 26 teeth treated without root end filling were successful, while 9 (64.3%) out of 14 teeth treated with apicectomy with retrofil were successful. CONCLUSION: Though apicectomized teeth without root-end filling had a higher percentage of success it was not statistically significant (p=0.15).

ISOLATION, CHARACTERIZATION AND IMMUNOCHEMICAL STUDIES ON FIBROUS PROTEINS FROM COWRY SHELL (CYPRAEA MONETA, LINNAEUS).

BACKGROUND: Biomaterials are non-drug substances used to treat, enhance or replace functions of body tissues or organs. Natural sources of biomaterials have recently become the focus of several research activities. Cowry shell constitutes one of the most promising natural sources of biomaterials because of its chemical stability, biodegradability and biocompatibility in the body. However, its applications may be limited due to immunogenic and toxic responses that may occur following implantation, hence this study. MATERIALS AND METHODS: Crude fibrous protein extracted with citrate buffer from pulverised cowry shells (Cypraea moneta (L)), was resolved into two components (CSP1 and CSP2) by gel filtration. Immunological studies were performed with antisera obtained from rabbits by double immunodiffusion and immunoelectrophoresis techniques. Mice treated with the proteins were observed for signs of toxicity and their liver, kidney, lungs and spleen were processed histologically. RESULTS: The native molecular weight of CSP1 and CSP2 determined by gel filtration were 91kDa and 33kDa respectively. CSP1 and CSP2 displayed single bands on SDS-PAGE with subunit molecular weight values of 19kDa and 19.5kDa respectively. Antisera obtained from rabbits immunised with the crude citrate buffer extracts precipitated the antigen in double immunodiffusion tests. Histopathological examinations revealed a dose-dependent damaging effect of the shell proteins on liver, kidney, lung and spleen tissues of the treated mice. CONCLUSION: This study showed that cowry shells contain fibrous proteins which are immunogenic and toxic in mice at relatively high concentrations, causing visible organ damage without concurrent physical manifestations.

Masticatory efficiency of shortened dental arch subjects with removable partial denture: A comparative study.

OBJECTIVE: The objective of this study was to compare the masticatory efficiency in subjects with shortened dental arch (SDA) before and after restoration with removable partial denture (RPD). MATERIALS AND METHODS: This was a prospective study carried out on 36 consecutive patients. The subjects were asked to chew 5 g of a measured portion of fresh raw carrot for 20 specified numbers of strokes. The raw carrot was recovered into a cup and strained through a standard mesh sieve of 5 mm by 1 mm, it was air dried for 30 min and weighed with FEM digital series weighing scale. The masticatory performance ratio was then determined. RESULT: The age range of the subjects was 34-64 years with the mean age being 52.2 ± 8.2 years. The difference between the total masticatory performance score at the post- and pre-treatment phases was statistically significant (P = 0.001). The improvement in masticatory performance was marked among the younger age groups (P = 0.001), unilateral free end saddle subjects (P = 0.001), and among the male gender (P < 0.05). CONCLUSION: Masticatory performance improved with the provision of RPD. However, the improvement was marked among the younger age groups, unilateral free end saddle subjects, and the male gender; thereby supporting the need for RPDs in patients with SDA.

Prevalence, pattern and severity of molar incisor hypomineralisation in 8- to 10-year-old school children in Ile-Ife, Nigeria.

AIM: This study aimed to determine the prevalence, pattern and severity of MIH in school children resident in a suburban population in Nigeria. METHODS: This was a cross-sectional study involving pupils aged 8-10 years resident in suburban Nigeria. Details of each pupil's socio-demographic variables were collected. Intra-oral examination was conducted to determine the presence of MIH, the affected tooth and the severity of the lesion. The association between the prevalence of MIH and socio-demographic variables of each child was determined. The predictors of MIH were also determined using a binomial regression analysis. RESULT: Eighty-three of the 469 children examined (17.7 %) had MIH. There was no significant association between sex (p = 0.58), socio-economic status (p = 0.09), age (p = 0.26) and MIH. There was also no significant difference in the number of teeth affected by MIH in the maxilla and mandible, and on the right and left side of the face. The most commonly affected teeth were the left mandibular molars. The occlusal surfaces of the first molars were mostly affected by MIH and the severity of MIH on the teeth examined varied from mild (80.8 %), moderate (14.0 %) to severe (5.2 %). CONCLUSION: The prevalence of MIH in this study population is consistent with previous reports. The non-association between sex and MIH prevalence, the varied severity of the lesion and association between MIH affectation of the first permanent molars and central incisors give more weight to the possible role of environmental factors in the aetiology of the lesion. The non-association between MIH and socio-economic status may serve as a distinctive feature of MIH and chronological enamel hypoplasia.

Comparative evaluation of perceptions of dental students to three methods of teaching in Ile-Ife, Nigeria.

BACKGROUND: The World Health Organization in 1994 recommended that dental education should be problem based, socially and culturally relevant, and community oriented. OBJECTIVES: To explore the perceptions of Pre-phase II (pre-clinical II) dental students on three methods of teaching used during two academic sessions. METHODS: All part IV dental students in two consecutive sessions undergoing pre phase II course in the Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife were recruited into the study. Three different modes of teaching that is, Problem based learning (PBL), hybrid PBL and traditional teaching were used to teach the students. A twenty two itemed anonymous questionnaire on a five point Likert scale was administered to the students at the end of the course. Six perceived factors were extracted from the questionnaire using factor analysis. RESULTS: There was a statistically significant difference (p < 0.01) between the overall mean of PBL method compared to the other methods of teaching. The perceived factor "communication with peers" had the highest mean score for PBL in both sessions (4.57 ± 0.58 and 4.09 ± 0.93 respectively). However, PBL method was very helpful in all the six perceived factors while the students perceived that the traditional method of teaching was not helpful in "interaction with tutors" and "challenge to critical thinking". CONCLUSIONS: The findings showed that students preferred the PBL method to other forms of teaching. PBL enhanced the students' communication skill, was very useful as pedagogic tool and improved their critical thinking.

Prevalence and clinical consequences of untreated dental caries using PUFA index in suburban Nigerian school children.

BACKGROUND: Dental caries is the most common childhood disease and the most frequent non-communicable disease worldwide. In developing countries, a vast majority of the caries remains unrestored. However, the severity and consequences of untreated dental caries among Nigerian children is unknown. OBJECTIVES: To determine the prevalence using the DMFT/dmft index and severity of oral conditions related to dental caries using the PUFA/pufa index in suburban Nigerian children. METHODS: The study population consisted of 1,266 randomly selected school children in Ile-Ife, Nigeria. Dental caries status was assessed using the DMFT/dmft index, described by WHO for epidemiological studies. The PUFA/pufa index was used to assess the clinical consequences of untreated dental caries. RESULTS: The mean dmft was 0.58 for the 4-6 years age group while the mean pufa score was 0.16 for the same age group. The mean DMFT score (0.16) was highest for the 13-16 years age group, while the mean PUFA score was 0.05 for the same age group. The prevalence of dmft > 0 was highest in the 4-6 years age group (16.9 %) while the prevalence of DMFT > 0 was highest in the 13-16 years age group (7.2 %). The mean pufa > 0 was highest in the 4-6 years age group (9.2 %). The overall caries prevalence was highest in the 4-6 years age group (17.4 %). Thirty-three percent of decayed teeth in the permanent dentition and 28.2 % of the primary dentition had signs of odontogenic infections. CONCLUSIONS: Despite the increase in the consumption of westernised diets by Nigerian children coupled with limited access to dental care, the prevalence was low but the clinical consequences of untreated dental caries was still high.

Facial approximation: evaluation of dental and facial proportions with height.

BACKGROUND: Fabrication of complete dentures requires the use of certain guidelines which are placed on the bite blocks to assist the clinician to have the maxillary anterior teeth restored to optimal dento-labial relations, in harmony with the overall facial appearance. OBJECTIVE: To explore if any relationship exists between dental and facial proportions as well as the height of the individuals. METHODS: Two hundred and four dental students of the Obafemi Awolowo University volunteered to participated in the study. The lower facial height, inter incisal, inter canine, and intercommisure distances, as well as the height of the participants were measured. The data were imputed, analyzed, and reported as simple frequency, means and standard deviations using the SPSS vs 11. Statistical significance was inferred at p<0.05. RESULT: The mean values of all the parameters measured were significantly higher in males than females. None of the mean values measured were coincident. However, a significant correlation exists between intercanine and interincisal distances(r=0.8) while a weak but significant negative correlation exists between the intercanine distance and the difference of the intercommisural and intercanine distances (r=-0.4) CONCLUSION: The study showed no relationship between intercanine distance, interincisal distance, lower facial height, and the height of the participants with the intercommissural distance. Hence, intercommissural distance may not be used in marking canine line during bite registration procedure. At best, 1.75-2.45 cm should be subtracted from the intercommissural distance to determine the intercanine distance.

Orbito-ocular soft tissue measurements in young adults--an indigenous Negro population study.

AIM: This study was named at determining normal orbital soft tissue parameters in young adults in an indigenous black population. METHODOLOGY: Prospective study on consentimg young adults in a Nigerian University with no previous orbito-facial trauma/surgery, strabismus, ptosis, telecanthus, and history of neurological diseases or previous ocular trauma were excluded. The age, sex and height of each participant were recorded. With the aid of a manual Sliding Vernier Caliper, the inner canthal distance (ICD), outer canthal distance (OCD), right horizontal palpebrae fissure length (RHPFL), left horizontal palpebrae fissure length (LHPFL). The results were imputed, analyzed and reported as simple frequency, means and standard deviations using the SPSS version 11 and statistical significant accepted at P < 0.05. RESULTS: Two hundred and four of participants of which 136 (66.7%) were males constituted the study population. Their ages ranged between 17-38 years with a mean and standard deviation of 23.6 ± 3.2 years. Their height ranged from 1.43-1.94 m with a mean and standard deviation of 1.70 ± 0.81 m. The mean and standard deviation for OCD, ICD, RHPFL and LHPFL were 99.6 ± 5.5 mm, 36.5 ± 3.3 mm, 32.5 ± 1.8 mm and 31.7 ± 1.9 mm, respectively. The range and mean ICD (28.2-45.4 mm and 36.5 mm) is greater than the range and mean palpebrae fissure lengths in either eye. Statistcally significant gender based differences were recorded in the mean OCD and ICD with higher values in in males. CONCLUSION: Normal soft tissue orbit-ocular parameters are presented for young adults in the population showing statistically significant mean larger values for males compared with female subjects.

Tooth sensitivity experience among residential university students.

OBJECTIVES: The aim of this study was to assess the experience of residential University students about 'sensitive teeth'. SUBJECT AND METHODS: Self-administered questionnaires were given randomly to students in all the residential hostels located in the University campus. Data on presence of sensitive teeth, initiating stimulus and duration of each episode of discomfort were elicited. History of common aetiological factors of tooth sensitivity was also taken. RESULTS: One thousand and nineteen responses (650 males; 369 females) were analysed in this study. Approximately 697 (68.4%) volunteers claimed to have sensitive teeth. Majority described their discomfort as sharp pain, cold as the initiating stimulus and drinking was mostly interfered with. Tooth sensitivity was found to be common among hard toothbrush users. Multiple regression analysis showed that hard toothbrush had a significant association with tooth sensitivity. Other common aetiological factors, such as history of gastric acid reflux, vomiting, soft drinks and the use of vitamin C were found to have a weak association with tooth sensitivity. CONCLUSION: Prevalence of tooth sensitivity was 68.4%. Presence of tooth sensitivity among these students was associated more with history of hard toothbrush use contrary to widely held belief that erosive agents were mostly responsible. Future studies are needed to provide more epidemiological data on tooth brushing and tooth sensitivity.

Bacterial infections of the head and neck fascial spaces in Nigerians.

BACKGROUND: Bacterial infections of the head and neck region remain a major public health concern in Nigeria despite the availability and widespread use of antibiotics in the country. OBJECTIVE: This study was conducted to determine the pattern, aetiology, management and outcome of head and neck fascial space infections at Ife. METHODS: All consecutive patients who presented with fascial space infections between January 1995 and July 2004 at the Maxillofacial Unit of the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria were admitted into the study. A structured questionnaire was completed for each patient and analyzed in respect of patients' demographics, source of infection, predisposing factors, location of infection; treatment and outcome. RESULTS: One hundred and three patients were managed during the study period. There were 55(53.4%) males and 48(46.6%) females with age ranging from 1-85 years. Submandibular space was the most common single space involved followed by the buccal space. The fascial spaces around the mandible were more involved those around the maxillae and scalp for all age groups. Four patients presented with Ludwigs' angina. Odontogenic infections arising from pulpitis, periodontitis and pericoronitis caused over 70% of the space infections. Microbial cultures showed mixed aerobic and anaerobic bacteriology. Management was by incision and drainage/decompression, removal of the source, use of antibiotics and supportive care. Two deaths were recorded in the course of this study. CONCLUSION: Bacterial infections of the head and neck region remain a major health hazard among Nigerians with spread of infection commonly involving the submandibular and the buccal spaces.

Evaluation of speech in patients with partial surgically acquired defects: pre and post prosthetic obturation.

AIM: Maxillectomy often results in a high level of morbidity with significant psychological and functional implications for the patient. Such disabilities include inability to masticate, deglutition, and speech disturbance. Unfortunately, little is known about the nature of the speech disturbance and the influence of the class of surgical defects in this group of patients. The aims of the present study were to assess the effectiveness of the maxillary obturator as a speech rehabilitation aid and to examine the influence of the classes of surgical defects on speech intelligibility (SI). MATERIALS AND METHODS: Twelve patients aged between 18 and 60 years with surgically acquired partial maxillary defects were included in this study. The patients were given immediate surgical obturators six to ten days after surgery, which were then converted to interim obturators by relining with tissue conditioner. Interim prostheses were used for two to three months until healing and resorption were found satisfactory after which the definitive obturators were fabricated. The SI test described by Plank et al. and Wheeler et al. was employed in this study. There were significant improvements in the mean SI score from 59.8% without prosthetic obturation, to 89.2% following interim obturation, and 94.7% following definitive obturation (p<0.005). Nine patients (75%) had class I surgical defects, two patients (16.67%) had class II defects, while only one patient (8.33%) had a class VI surgical defect. None of the patients had class III, IV, or class V surgical defects. There was an improvement in the SI score from class I to class VI without obturation, after insertion of interim obturator, and after insertion of the definitive obturator. CONCLUSION: Results support the widely held view that the maxillary obturator is a useful speech rehabilitation aid. It also shows immediate, interim, and definitive obturators are all important in the speech rehabilitation of patients with surgically acquired maxillary defects. Moreover SI is affected by the class of defect.