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.

Sociodemographic determinants of usage of removable partial denture in a tertiary hospital: A retrospective study.

Objective: To determine the influence of sociodemographic characteristics on pattern of removable partial denture use in a tertiary institution over a one-year period. Methods: This was a retrospective study using records of partially dentate patients seeking replacement for their missing teeth within one-year duration. Information retrieved from the patients' records included demographic characteristics such as gender, age, marital status, occupation, arch type, number and reasons for missing teeth and type of removable partial denture. Statistical analysis was performed using statistical package for social science (SPSS) version 17 (Chicago, IL.). The analysis was done using frequency distribution, cross tabulations, t test and test of significance with chi square. P<0.05 was considered statistically significant. Results: A total of 98 patients were seen over the study period with a male/female ratio of 1:1.45. The patients' age ranged from 20 to 89 years with a mean age of 47.19 ± 18.37. The number of teeth replaced ranged from 1 to 17 with a mean of 3.13 ± 3.30 teeth. The mean number of missing teeth was significantly higher among patients aged 50 years and above (p = 0.002). Majority (69.4%) of the patients were married and 59.2% were working class (skilled and unskilled). The Kennedy's Class III saddle was the most prevalent in the maxilla while Class IV was most prevalent in the mandible; a difference that was statistically significant. Conclusion: Socioeconomic status, age and gender influenced the use of removable partial denture.

An analysis of treatment outcome in traumatised anterior teeth with delayed presentation.

Introduction: This study was designed to analyse the treatment outcome of traumatized anterior teeth with delayed presentation among adult patients. Method: A longitudinal study carried out among adult patients with traumatized anterior teeth. Data was obtained by means of a pre-tested questionnaire consisting of history taking, clinical examination and record of treatment. Data collected was analysed using the Statistical Package for Social Science 21.0. Results: Out of 163 patients who sought treatment for traumatized anterior teeth, 102 presented a month or more after the traumatic incident giving a prevalence rate of 62.3% for delayed presentation. The main reason for seeking treatment was disfigured teeth. More than half (57.8%) of the participants presented with one or more complications. Evaluation revealed that 3 (2.7%) of the participants had failed restoration at 1-month recall and this was statistically significant. Conclusion: Delayed treatment has an implication on the type, complexity and cost of treatment. Evaluation after treatment for traumatized anterior teeth has to be done for a minimum of 3 months to ascertain optimal result. Oral health education should focus on the need to visit a dentist immediately after a traumatic episode with or without loss of dental hard tissue.

Hepatitis B virus depicts a high degree of conservation during the immune-tolerant phase in familiarly transmitted chronic hepatitis B infection: deep-sequencing and phylogenetic analysis.

When intrafamilial transmission of hepatitis B virus (HBV) occurs, a virus with the same characteristics interacts with diverse hosts' immune systems and may thus result in different mutations to escape immune pressure. In this study, the HBV genomic characterization was assessed longitudinally after intrafamilial transmission using nucleotide sequence data of phylogenetic and mutational analyses, including those obtained by deep-sequencing for the first time. Furthermore, HBeAg-anti-HBe profile and variability of HBV core-derived epitopes were also evaluated. Strong evidence was obtained from intrafamilial transmission of HBV genotype D1 by phylogenetic inferences. HBV isolates exhibited high degree (~99%) of genomic conservation for almost 20 years, when patients were persistently HBeAg positive with normal amino transferase levels. This identity remained high among immune-tolerant siblings. In contrast, it diminished significantly (P = 0.02) when the mother cleared HBeAg (immune clearance phase). By deep-sequencing, the quantitative analysis of the dynamics of basal core promoter (BCP) (A1762T, G1764A; A1766C; T1773C; 8-bp deletion; and other) and precore (G1896A) variants among HBV isolates from family members exhibited differences during the follow-up. However, only those from the mother showed amino acid variations at core protein that would impair their MHC-II binding. Hence, when intrafamilial transmission occurs, HBV was highly conserved under the immune-tolerant phase, but it exhibited mutations more frequently during the immune clearance phase. The analysis of the HBV BCP and precore mutants after intrafamilial HBV transmission contributes to a better understanding of how they evolve over time.

Relationship between obesity and oral diseases.

OBJECTIVE: The aim of this study was to determine the relationship between obesity and periodontal status and dental caries experience of a group of Nigerian dental patients. MATERIALS AND METHODS: Participants were selected from patients attending dental outpatient clinics of the University of Benin Teaching Hospital, Benin City, Nigeria. Their weight and height were measured and body mass index (BMI) estimated in kg/m 2 , gingival health assessed using bleeding on probing index, oral hygiene estimated using the simplified oral hygiene index (OHI-S), periodontal health estimated using the basic periodontal examination (BPE) and caries experience was estimated with the decayed, missing, and filled teeth (DMFT) index. RESULTS: A few participants (3.8%) were underweight, 52.6% fell within the normal BMI range, 28.2% preobese, 12.2% obese class I and 3.2% obese class II. The mean OHI-S score was 2.16 ± 1.13 among the overweight participants and 2.05 ± 1.13 among those who are not (P = 0.543). The mean DMFT score was 3.03 ± 4.25 among the overweight participants and 2.32 ± 3.01 among those who are not (P = 0.223). Sixty-five percent of participants with BPE score of 0, considered to signify periodontal health, had normal BMI while all the participants with the worst BPE score recorded belong to the obese 1 group (P = 0.070). The binary logistic regression revealed that the likely predictor of gingival bleeding in the study is BMI between 35.0 and 39.9 (obese class 2) (P = 0.046, odds ratio = 0.07, 95% confidence interval = 0.01-0.96). CONCLUSION: It can be concluded from this study that there is no statistically significant relationship between obesity and periodontal status and dental caries experience in the studied group of dental patients. Increased BMI may however be a predictor of gingival bleeding.

Analysis of sequences of hepatitis C virus NS5A genotype 1 in HIV-coinfected patients with a null response to nitazoxanide or peg-interferon plus ribavirin.

Even though new drugs have been approved for treatment of hepatitis C virus (HCV) infection, the risk of drug-drug interactions and concern about overlapping toxicities has hindered the development of studies in HIV/HCV-coinfected individuals. Traditional treatment with pegylated interferon plus ribavirin (peg-IFN + RBV) is very expensive and has a low rate of sustained virological response in coinfected patients, especially if they are infected with HCV genotype 1. Nitazoxanide (NTZ) is a drug that is being evaluated for the treatment of chronic HCV infection, both in HCV-monoinfected and HIV/HCV-coinfected patients. Understanding the NTZ resistance mechanism could allow the development of resistance to be minimized and would expand the treatment options, mainly in special populations such as HIV/HCV-coinfected patients. Similarly to IFN, NTZ increases the activity of the cellular protein kinase activated by double-stranded RNA (PKR), a key kinase in the innate antiviral response. In order to elucidate whether sequence heterogeneity in the PKR-binding domain of HCV NS5A genotype 1 could influence the antiviral activity of either NTZ monotherapy or peg-IFN + RBV, baseline and end-of-therapy plasma samples from two groups of eleven non-responder HIV/HCV-coinfected patients that had received NTZ or peg-IFN + RBV were studied. Most of the HCV NS5A sequences examined at the end of therapy did not change from the baseline, even after 30 days course of antiviral therapy. An extensive comparison of HCV NS5A genotype 1 and 4 sequences from the database with reported IFN therapy outcome was performed in order to infer their phylogenetic relationships. The HCV genotype 1 NS5A nucleotide sequences from therapy-non-responder patients were intermingled amongst those from the database, irrespective of their IFN-therapy outcome. When comparing NS5A-PKRBD amino acid sequences, significant differences were observed in genotype 4, but not in genotype 1 (p < 0.0001 and p > 0.05, respectively). In conclusion, despite IFN and NTZ sharing the protein kinase activated by double-stranded RNA as their cellular target, the HCV genotype 1 strategy to counteract the IFN action mediated by NS5A ISDR/PKRBD does not explain drug resistance in HIV/HCV-coinfected patients. Other viral factors that are possibly involved are discussed as well.

Endodontic working length of permanent maxillary central incisors in Nigerians.

BACKGROUND: The permanent maxillary central incisors are critical to dento-facial aesthetics in humans. Their restoration in the event of periapical infection or traumatic injury to the pulp requires an accurate determination of the root canal working length; an important outcome predictor in endodontic treatments. AIM: To determine the standard working length of permanent maxillary central incisor in a Nigerian population. METHODS: This study was carried out between March 2008 and June 2010. The study involved Nigerian patients of both gender, receiving endodontic treatment of the permanent maxillary central incisor. The study participants were selected based on a predetermined exclusion and inclusion criteria. The working lengths of the patient's teeth were determined using the radiographic method and Electronic apex locator. RESULTS: The average working length of the permanent maxillary central incisor of the patient's was 25.0 ± 1.7 mm while the values in males and females were 25.4 ± 1.2mm and 24.4 ± 2.2mm respectively. The male patients had longer working length than the females (P<0.05). The study also revealed that the most common indication for endodontic treatment in permanent maxillary central incisors in the studied population was trauma. CONCLUSION: The endodontic working length of permanent maxillary central incisors in adult Nigerian population was greater than that reported in Caucasians and Asians. This variation should serve as an important reference for endodontic procedures in the maxillary central incisors of adult Nigerians and perhaps others nationals from the West Africa sub region.

Analysis of the PKR-eIF2alpha phosphorylation homology domain (PePHD) of hepatitis C virus genotype 1 in HIV-coinfected patients by ultra-deep pyrosequencing and its relationship to responses to pegylated interferon-ribavirin treatment.

Chronic coinfection with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) is among the greatest challenges facing public health worldwide. In this population, the response to hepatitis C therapy by treatment with pegylated interferon plus ribavirin (PEG-IFN+RBV) is lower than in HCV-monoinfected patients, particularly in those infected by HCV genotype 1. A PKR/eIF-2α phosphorylation homology domain (PePHD) within the E2 protein has been found to interact with PKR and inhibit PKR in vitro, suggesting a possible mechanism for HCV to evade the antiviral effects of IFN. The aim of this work was to analyze the amino acid conservation in the HCV-E2-PePHD and quasispecies diversity among HCV-HIV-coinfected patients exhibiting sustained virological response, non-response, or partial response with viral relapse to PEG-IFN+RBV by ultra-deep pyrosequencing. For this purpose, HCV-E2-PePHD PCR products were generated and sequenced directly for four patients with a sustained response, seven patients with no virological response, and four patients with viral relapse before and after treatment with PEG-IFN+RBV. HCV-E2-PePHD amino acid sequences were obtained for isolates from serum collected before and during treatment (24 h, 4 weeks, and 12 weeks). Quasispecies analysis of the HCV-E2-PePHD and flanking genomic regions was performed using 454/Roche pyrosequencing, analyzing 39,364 sequence reads in total. The HCV-E2-PePHD sequence at the amino acid and nucleotide level was highly conserved among HCV genotype 1 strains, irrespective of the PEG-IFN+RBV response. This high degree of amino acid conservation and sporadic mutations in the HCV-E2-PePHD domain do not appear to be associated with treatment outcome. The HCV-E2-PePHD sequence before or during treatment cannot be used to predict reliably the outcome of treatment in patients coinfected with HCV genotype 1 and HIV.

Perception of HIV/AIDS among preclinical dental students.

OBJECTIVE: To determine the knowledge, attitude and willingness of preclinical dental students to treat HIV/AIDS patients in the future. METHOD: The sample comprised 150 students of both genders drawn from the third and fourth year dental students of the University of Benin, Benin City. One hundred and fifty questionnaires were self-administered, with 139 (92.6%) retrieval. The parameters measured were knowledge, status, immunization against hepatitis B virus, willingness to treat, knowledge of post exposure prophylaxis (PEP) and its protocol in the of University of Benin Teaching hospital (UBTH). RESULTS: Data analysis showed that 100 (71.9%) students rated their knowledge of HIV/AIDS as high and very high. Sixty-three (45.3%) students thought that HIV was a contagious disease while 46 (33.1%) felt HIV was more infectious than tuberculosis or any of the strains of hepatitis virus. Only 59 (42.4%) students knew their HIV status. One hundred and twenty seven (91.4%) students felt that professional oral health care will be beneficial to HIV/AIDS patients; while fifty-one students (36.7%) are not prepared to administer dental care to HIV/AIDS patients in future. Majority of respondents adjudged health workers to be more at risk than sex workers. Forty students comprising 28.8% of the study population had been immunized against Hepatitis B. Ninety- four (67.7%) students had no knowledge of PEP while 122 (87.8%) students did not know the PEP protocol in UBTH. CONCLUSION: Although a large number of these students claim to be knowledgeable about HIV/AIDS. It is obvious that a true understanding is lacking. Concerted effort should be made to change their perception by implementing a curriculum designed to enhance the knowledge of dental students; if we hope to save HIV/AIDS patients from the discrimination of future healthcare givers.

Ameloblastomatous Change in Radicular Cyst of The Jaw in a Nigerian Population.

OBJECTIVE: To determine the incidence, age, gender, jaw-sites and subtypes of radicular cyst, and to determine the incidence of ameloblastomatous change in radicular cyst in a Nigerian population. METHOD: A 10-year retrospective analysis of all diagnosed orofacial lesions in the Department of Oral Pathology and Medicine, University of Benin Teaching Hospital, Benin City, Nigeria. RESULTS: From the 785 diagnosed orofacial lesions within the study period; there were 54 (6.9%) cases of radicular cysts of the jaws. The peak age group was the 3(rd) decade (n=23, 42.6%) with a mean age of 31 ± 1.7 years. There were 29 (53.7%) males and 25 (46.3%) females, giving a ratio of 1.2:1. The mandible was the commonest jaw-site (n=32, 59.3%). There were 12 (22.2%) cases of periapical cyst which were significantly associated with anterior maxillary site (n=8, 14.8%) [p=0.001]. Seven (13.0%) cases of cystic ameloblastoma were diagnosed among the radicular cysts, with a predilection of the lesions for 3(rd) and 4(th) decades of life (n=6, 11.1%), and posterior mandible (n=5, 9.3%). CONCLUSION: This study showed a low incidence of radicular cyst of the jaw among orofacial lesions and a relatively higher incidence of ameloblastomatous change in radicular cyst compared to previous reports. Immuno-histochemical examination is recommended to differentiate radicular cyst with ameloblastomatous-like change from cystic ameloblastoma arising from radicular cyst.

Reasons and pattern of tooth mortality in a Nigerian Urban teaching hospital.

BACKGROUND: Studies from Nigeria have documented different reasons for tooth mortality and regular follow-up studies to determine any changes in reasons and pattern among Nigerians appears not to be common. The purpose of this study was to determine the reasons and pattern of tooth mortality among Nigerians and the changes that might have occurred after 38 years of the first report. MATERIALS AND METHODS: The case records of patients seen at the Oral Surgery clinic of the University of Benin Teaching Hospital between March 2007 and February 2008 were retrieved from the Medical Records Department and analyzed for age, gender, reasons for extraction, tooth extracted, frequency of extraction, and mode of extraction. RESULTS: A total of 990 patients were referred for exodontia and 1050 teeth were extracted from 397 (40.1%) males and 593 (59.9%) females of age 14--89 years. The reasons for extraction include caries and its sequelae (n = 905, 86.2%), periodontal disease (n = 69, 6.6%), trauma (n = 41, 3.9%), orthodontics (n = 24, 2.3%), failed endodontics (n = 5, 0.5%), prosthetics (n = 4, 0.4%), pericoronitis (n = 2, 0.2%). The most frequently extracted teeth were the lower right first molars (n = 109, 10.4%) and the lower left first molars (n = 95, 9.0%), respectively. Molar teeth (n = 830, 79.0%) were more frequently extracted while canines (n = 13, 1.2%) were the least. The lower molars were more commonly extracted (n = 479, 45.6%) followed by upper molars (n = 351, 33.4%). The age range of 21-30 years was more commonly referred for extraction with the most frequently extracted teeth being the lower left first molars (n = 32, 3.0%) in females and (n = 27, 2.7%) in males, respectively. CONCLUSION: Tooth mortality in Nigerians is significantly associated with dental caries and its sequelae especially in younger patients.

Long-term monitoring drug resistance by ultra-deep pyrosequencing in a chronic hepatitis B virus (HBV)-infected patient exposed to several unsuccessful therapy schemes.

The aim of this study was to analyze the spectrum and dynamics of low-prevalent HBV mutations in the reverse transcriptase (rt) and S antigen by ultra-deep pyrosequencing (UDPS). Samples were obtained from a chronically infected patient who was followed throughout a thirteen-year period. This technology enabled simultaneous analysis of 4084 clonally amplified fragments from the patient allowing detecting low prevalent (<1%) mutations during the follow-up. At baseline, HBV sequences were predominately wild-type. Under sequential HBV monotherapies including lamivudine, adefovir and entecavir, a high frequency of rtM204I mutation was detected initially as unique and then coexisting with rtM204V. Both mutations were statistically associated with rtA200V and rtV207I, respectively. Once the entecavir and tenofovir combined therapy was started, polymerase and consequently envelope gene mutations appeared at several positions at a higher frequency than before, including the entecavir resistance-associated mutation rtT184L.